Thursday, November 5, 2009

The change

I picked up a copy of Bust magazine for the first time yesterday and it contained two birth control related articles - one about a new female condom, and the other about the fertility awareness method. I'm beginning to wonder if there's a whole lot of women coming off the pill at the moment, either in direct response to the negative news around Yasmin or because of a more general growing consciousness of the lack of choice, individual and social, in taking the pill.

I came across an article on ABC news about withdrawal problems experienced by women coming off the contraceptive injection Depo Provera. Women had written in to them complaining that even if they had been fine whilst on this medication, once stopping they experienced bad mood effects, nausea and headaches. The final quote of the piece from Dr Louis Weinstein typically waves away these issues, saying that it wasn't "fair" to blame the injection when it could be any manner of other problems in the women's lives.

This of course is true, and pretty difficult to argue against, particularly if you are one woman in Dr Weinstein's office. But I'm right now trying to think of any other drug a person could take that would be so easily dismissed as the cause of physical and emotional changes. Even if the answer is to give a person another drug to combat the side effects of the first, it is rare that the drug is so willfully pushed out of the equation. The doctor's attitude is given support with talk of the benefits of the injection in terms of preventing unwanted pregnancy in unreliable teenagers not trusted with the pill and, worryingly, young women with learning difficulties.

That's all very well and good, although of course it isn't, but it is not a good enough reason to dismiss the possibility of side effects entirely in some sort of utilitarian ruling of the greatest good for the greatest number. It sounds a bit like the argument used to support vaccinating children, except women won't die or cause others to die if they don't have the contraceptive injection, and there are other choices available to them that do just as good a job of stopping pregnancy.

I've been concerned to see that a couple of articles on the side effects of the pill in magazines lately have suggested the injection, the patch, the ring and the implant as alternatives. I worry that negativity surrounding the pill will focus on the lack of offered alternatives rather than the reasons for its side effects and therefore usher women towards other hormone-based methods rather than other non-hormone based methods. The injection, ring etc might well be fine for some women, but they still act to suppress the natural hormone cycle just like the pill. And a woman is less in control because she can't just decide to stop if she feels unwell.

This population control issue has been gaining ground recently with environmentalists. Luckily, those same environmentalists tend to think women shouldn't be peeing a lot of chemicals into the sea too so they aren't backing the pushing of the pill. As I have said before if criticising the pill causes unwanted pregnancies this only goes to highlight how important it is that we all get over our myopic view of contraception and talk about alternatives so women know how to use them if they want to.

Anyway, so withdrawal symptoms - as I have been saying, the pill can have withdrawal effects. If I think back to how I would be on the week I would stop the pill every three months - tired, achey, feverish, like I had the flu - it makes sense that I would feel bad when I stopped entirely. I have had a couple of meltdowns this week of the kind I haven't seen since my Yasmin experience. It's not that I wouldn't expect to be feeling somewhat low and worried in my life right now, it is more that I am much less able to cope with feeling that way. Rather than having a grasp of the feelings and an overarching rationality when I start getting stressed it's like quicksand. The connections in my brain and body that are meant to kick in and calm me down, and the wider perspective that should be revealed, are lost, and I just look deeper into the big black hole.

It gets very dull to keep repeating the obvious - women who don't take the pill feel bad sometimes too - but I think if a lot of women are coming off the pill right now then it is partly due to wanting to feel better than they have been, but also partly because - as Hannah remarked in the last post - they want to know if they would be experiencing life in a brighter, happier, more relaxed and joyful way if they weren't on the pill. Women are curious to know if after five, seven, ten years their true perspective and nature is different. Of course, as Hannah said, it might not be.

That upon stopping you might suddenly feel particularly bad probably causes many women to go running back to the pill. Also the fear of pregnancy, and the effect that might have on your sex life and relationship must test some women's resolve. Both these issues have certainly tested mine.

As you might be able to tell from my posts I'm feeling rather foggy-headed this week and less motivated than before. There's always that nagging worry that this won't pass, even though I've heard from tons of women who say it does. On the other side there's the knowledge that with the pill all out your system you can't rely on it as an explanation for your moods, even if like me you struggled a long enough time to realise the pill could be the cause.

It's like some weird abusive relationship of co-dependency - once you know the pill's effect, the lack of control and self-understanding fostered through taking it then makes you reluctant to take responsibility for your moods. If you are left wondering who you really are and then feel pleased to have some power from your knowledge of the pill, it can be sort of scary to carry on without it. I'm pretty sure next time I'm stressed out, in a couple of months or so say, I will be able to cope, but I feel so detached from my self at the moment it's difficult to be sure. Of course it's this blurriness of lines when talking about mood and emotions that has held back acknowledgement of the potential impact of the pill.

The FDA has approved a new female condom named FC2 and made by the Female Health Company. I liked this statement from a WHO study about the motivation behind the creation of FC2:

"Globally, health and human rights advocates have been demanding that scientists develop fertility regulation methods that are safe and reversible, under the control of the user, not systemic in action, which protect the user against STIs and HIV, and do not need to be provided by a health service. The female condom comes closer to these requirements than any other family planning method."

I also found this instructional video sort of fascinating. Like I said before, a lot of these alternative methods seem so hokey and silly precisely because many of us are lifetime followers of the pill and have had little to no experience with anything else other than male condoms. The pill's cultural dominance has made female condoms seem bizarre, when actually they look easy to use and quite sensible.

I'll talk about the Fertility Awareness Method next time. It's not like the Rhythm Method at all, and although I doubt I'll ever be brave enough to use this way alone as contraception it is actually very useful in terms of helping women gain confidence in their bodies and to feel in control and secure once they come off the pill. Not only does it allow you a better understanding of your body's cycle but can also give the support needed to make the leap from the pill to condoms and spermicide or something else.

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