How Safe Is Your Contraceptive Pill?
The Debrief: We’ve all been on it for years, ‘treating’ everything from irregular periods, acne and impending swimming lessons but, as accusations circulate regarding its safety, do we need to think twice about swallowing the medical advice?
Fallen Kurek was at home when she suddenly started to struggle to breathe. The 21-year-old turned blue and was rushed to hospital where, three days later, she was pronounced dead. The cause of death was recorded in the hospital as a pulmonary embolism on her lung. Her parents Brian and Julia Kurek, however, are convinced that their daughter died after complications caused by her oral contraceptive pill.
Fallen, a teaching assistant from Staffordshire, had been prescribed Rigevidon to regulate her periods and had taken the combined pill for 25 days. During that time, Fallen had started to complain of breathlessness and persistent pain in her ribs and her legs. As medical professionals started to look into the cause of her death, it transpired that Fallen had a large blood clot on her lung. Her mother, Julia, spoke to the Birmingham Mail last week and said of the paramedics who were dealing with her daughter:
‘While they were working on her someone came in to talk to me. They asked me whether there was any heart problems in the family, or if Fallan had taken drugs – definitely not. The third question was: “Is she on the pill?” I said: “Yes, is that relevant?” He said: “We know what it is” and off he went.
‘Brian and I just looked at each other – we couldn’t believe it…. We felt angry when they first mentioned it could be the Pill. She was only on it to regulate her periods. I couldn't believe nobody had said the Pill could do this.’
A full inquest is planned for a date later this year where the cause of death will be established, but Fallen's story has raised some important questions regarding the safety or oral contraceptives. A new study by the University of Nottingham showed that more than one million are at increased risk of developing dangerous blood clot because of third generation pills like Yasmin, Femodene and Marvelon (which were shown the raise the chance of blood clot four fold compared with women who do not take oral contraceptive). Scientists recently found that third generation oral contraceptives caused 14 deaths a year in France, prompting GPs in this country to be ordered to warn their patients of the risk of developing potentially life-threatening blood clots.
The numbers are certainly not encouraging, but the Medicines and healthcare Regulatory Agency remain steadfast in their assurance of the safety of the Pill. A spokesperson told us: 'Women should continue to take their contraceptive Pill. These are very safe, highly effective medicines for preventing unintended pregnancy and the benefits associated with their use far outweigh their risks.
Scientists recently found that third generation oral contraceptives caused 14 deaths a year in France
'The safety of contraceptive Pills was reviewed at European level in 2014 and the review confirmed that the risk of blood clots with all contraceptives is small. The benefits of any combined hormonal contraceptive far outweigh the risk of serious side effects – prescribers and women should be aware of the major risk factors for blood clots and the key signs and symptoms.'
Like a huge number of women my age (I’m 26), Fallen’s story really resonated with me because I have been on some form of hormonal contraception for the vast majority of my adult life (I had taken three different types of oral contraceptive and tried both the implant and the hormonal coil before coming off everything a few months ago). I'm struck by the ease with which I was first able to go and get the Pill when I was only 14 years old, without any parental supervision, from a family-planning clinic in the waiting room of a local church in South West London, where I grew up. There was a pool party I wanted to go to in two weeks and everyone in my year was going to be there _ I’d have to skip it if I was on my period and ‘needed’ a solution. I was prescribed Microgynon, no questions asked, without any proper inquiry into my sexual activity (I was a virgin) or my family’s medical history (breast cancer is prevalent in my family) and was on it until I was 21.
I am by no means alone, statistics show that there is a sizeable percentage of people who are taking oral contraceptives for other reasons that pregnancy prevention. A survey from the National Survey of Family Growth showed that the most common reasons included reducing cramps or menstrual pain (31%); menstrual regulation, including reducing the affects of migraines and other menstrual ‘side effects’ (28%); treatment of acne (14%) and treating endometriosis (4%). Teenagers between 15-19 are more likely to use the Pill for solely non-contraceptive purposes (33%). Dr Ellen Lee, a General Practitioner, described how she has experienced an increase in the number of patients, especially those in their late teens and early 20s, who have inquired about going on oral contraceptive for reasons other than pregnancy prevention. ‘I’d say it accounts for around 4 in every 10 patients in this age range in my practise, with concerns around acne being the most common reason for enquiry. It’s my job to listen and make patients aware of the risk, especially if they are young.’
Anyone who has suffered with acne might not quibble using oral contraceptive to treat the issue, but how have we got into a situation where contraception has virtually become a secondary reason for prescribing the Pill? Here's a sample of quotes from women when I asked them why they were first prescribed the Pill.
‘I went on the Pill at 15 because I had become sexually active, but I also chose the Pill because I’d heard it would give me bigger boobs.’ Emma Gregory, 29.
‘I lost a lot of weight when I first went to uni and the doctor thought the Pill would regulate my periods, which were only coming once every few months.’ Grace Williams, 24.
‘The doctor thought it might help with my PMS.’ Cat Deacon, 23.
‘I was going on holiday. That was it really. I was on it for a decade.’ Helen Smith, 27.
We're not imagining it either - the culture around prescribing the Pill is that it's a one-size-fits-all cure for any number of ailments: ‘I think there has been a culture for a great number of years of seeing the Pill as a gateway to fixing all the problems of being a woman, both physical, psychological, emotional and even practical,’ explains a 31-year-old doctor who wanted to remain anonymous. ‘I don’t believe that that’s particularly ethical, especially if a patient isn’t made aware of the risks. When you take the Pill, your sex hormones are suppressed and replaced with synthetic hormones in one steady stream and your natural monthly fluctuations are repressed. This disrupts all of the systems related to your hormones including your metabolic and endocrine systems and even your immune system, which can lead to side-effects. It’s also been my experience that patients in the UK are prescribed the cheapest pill available as standard, despite the fact they might have the most unpleasant side-effects both short and long-term. Women are not given anywhere near enough information about what they’re taking and if they should be taking anything at all. Studies show the side effects can include anything from weight gain, to a loss in libido right the way up to blood clotting and cancer.’
The culture around prescribing the Pill is that it's a one-size-fits-all cure for any number of ailments
Holly Grigg Spall, author of Sweetening The Pill, sees the mass use of the Pill as gross negligence on a grand scale. She told us:
‘Newer versions of the Pill are even riskier than older generations of these products. We make comparisons between pills, instead of between using them and not using them - which would throw the stats in even starker relief. This is an unnecessary drug for most women and is a "lifestyle" drug for many. We ought to be using menstruation as a vital health sign, like blood pressure, to monitor the health of young women because menstrual problems can indicate underlying issues that need real treatment rather than to be masked.
Our current medical understanding of the female body hasn't progressed all that much from the Victorian era. Fertility is seen as an illness, pregnancy a disease, and the female reproductive system as problematic or useless until involved in having a baby. We think we can switch it off and on without whole body consequences. And the long-term risks are not properly understood - I think we are part of a mass experiment on women (or "the greatest experiment ever performed on women" as Barbara Seaman called it).’
They are damning words, but it is of course important to mention that the the Pill has given women more freedom and control of their reproductive destiny. Years before she founded Planned Parenthood – an American institution providing reproductive and maternal and child health services – dreamed of a ‘magic pill’ that would put women in charge of their own fertility. She had been a nurse and saw, first hand, the misery brought on by unwanted pregnancies and botched abortions of women in the ward who had to rely on their partner’s compliance for birth control. In 1920, she wrote a woman who relies on a man for firth control is ‘exploited, driven and enslaved to his desires.’ The importance of the Pill in safeguarding women’s rights cannot be underplayed, but is its important social impact reason enough to continue taking it as your standard method of contraception?
As the we ready ourselves for the inquiry into Fallen’s death, is it time we started to reconsider our options?
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