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Doctors Hear Me Out: Oral Contraceptives Are not Right for All Patients

While at the nail salon recently, I overheard a woman sharing her struggles with oral contraceptives. I found her experience to be strikingly familiar.

I thought back to when I was prescribed my first oral contraceptive. Within a month of taking the pill, I lost complete control over my emotions and stopped going to school and eating altogether.


I spent the next few years trying other pills, only to have experienced a series of unpleasant side effects. From uncontrollable mood swings to menstruating three times a month, I was growing desperate for an alternative solution, but never properly informed of one.


Medical professionals have always downplayed my experience, telling me I was the exception and not the rule. As it turns out I wasn’t the exception after all. According to a UK-based study, most “doctors routinely dismis[s] or disregar[d] women’s reports of adverse side-effects” while on the pill.  


Yet, researchers have discovered that women looking for hormonal contraceptives are overly prescribed the pill, as opposed to being offered alternatives such as the patch or the ring. I then started questioning whether the pill was truly the best solution for all women.


And let’s be clear, I don’t think oral contraceptives are bad. Medication is relative and oral contraceptives are generally safe for non-smoking, healthy women. Yet, after learning that 75 per cent of women in Canada take oral contraceptives in their lifetime, I am here to tell you that the pill is not the be-all, end-all.


For starters, studies have found a correlation between the use of oral contraceptives and depression rates. Given the fluctuation of serotonin levels when using hormonal birth control, some women may develop premenstrual dysphoric disorder.


While a Harvard study showed that PMDD only affects a little over 2 per cent of women using hormonal birth control, researchers have found that non-hormonal methods, such as copper intrauterine devices or condoms, pose little to no risk of developing depression.


Young women, especially, should monitor symptoms of increased crying, excessive sleeping, and eating disorders when taking oral contraceptives, which have all been proven to be legitimate side effects.


While some doctors may push their patients to stick to the pill or downplay their struggles with mental health, just as mine did, women should not feel pressured to continue using the pill if their quality of life is affected.   


The next thing to consider is how oral contraceptives can interfere with other medications you may be taking.


Now let’s be clear, I am no doctor. When I was prescribed a series of medications, alongside my pill, I never stopped to wonder how the medications would interact, nor was I ever informed.


Recent research, nonetheless, has found that women taking medications containing psychotropic agents, commonly found in antidepressants, are more at risk of having side effects from oral contraceptives. The researchers also discourage the use of oral contraceptives altogether for women using antiepileptic drugs, used to treat seizures.


Given that antidepressants are among the most prescribed medications of females in Canada, women ought to be aware of the potential interactions between their medications. One study conducted in Sweden even found a strong overlap between women using both hormonal contraceptives and antidepressants.


While researchers are still investigating how two types of medications interact, some research suggests that using oral contraceptives may affect the efficiency of particular drugs.


As such, healthcare providers should take extra care to walk their patients through possible side effects and drug interactions, validating their experiences and not completely shutting the door to alternative solutions.


I think overemphasis put on the pill and the lack of patient-doctor communication falls into the greater issue of medical gaslighting—the tendency for medical professionals to dismiss valid symptoms of women.


Many articles published by Chatelaine, The Atlantic, and The Guardian, explore the experiences of women gaslit by medical professionals when expressing concerns over their sexual/reproductive health and their experiences on the pill.


I am not here to tell you that you should only be practicing abstinence to avoid pregnancy or meditating to ease those excruciating menstrual cramps. Birth control pills might work for you. They work quite well for most people, but not all.

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