Saturday, August 16, 2014

The Lifestyle Possibilities of the Pill

It's called the curse for a reason. For many women, the menstrual cycle is a monthly ordeal of physical and emotional suffering.  First there's the pre-menstrual headaches, mood swings and difficulty concentrating. Then there's the stabbing ovulation pain or mid-cycle breast soreness. And that's before you even get to the debilitating cramps and heavy bleeding.

The oral contraceptive pill is often touted as a good solution to these problems. But as Dr Alice Roberts described in a recent Guardian article, it doesn't always work that way. Sometimes the hormonal ups and downs of suddenly stopping the pills every month can cause worse pre-menstrual symptoms than ever. But there's another choice. Most birth control pills are suitable to be taken continuously for several months at a time, or for as long as you want, meaning few or no periods at all. No blood, no pain, no mood swings.

Using contraception this way is common in the US, where extended-cycle pills are available as a lifestyle choice and marketed as brands such as Seasonale and Seasonique. But it's an option rarely offered on the NHS here - possibly in part for cost reasons, and also simply because of lack of knowledge on the part of GPs here. Many women in the UK just aren't aware that it's a possibility, and in many cases neither are their doctors.

When I first started taking birth control in my early 20s, freshly graduated from my biochemistry degree, I checked out the formulations of some commonly prescribed pills, and found that the popular combined pill Microgynon 30 contains exactly the same active ingredients as Seasonale, the 'four-periods-a-year' pill sold in the US. But when I asked my GP about it, he looked genuinely baffled. "That's impossible. That's not how you take these pills."

I did it anyway. My body, my choice. My money too - I pay for my birth control privately these days, preferring the choice and convenience of it - so I'm not expecting the NHS to subsidise my lifestyle choice.

There are risks associated with hormonal contraception, and these shouldn't be underplayed. There's evidence that some pills increase the risk of certain cancers, including breast and cervical cancers (though they do reduce your risk of others, such as ovarian cancer) and cardiovascular problems. Some women find it causes depression or weight gain. It's not safe or suitable for everyone, no matter how you take it.

There's a certain branch of feminism that would go further and say it's bad for all of us. Free yourself from the patriarchal medical establishment and its control over your fertility. Inga Muscio's third-wave feminist manifesto 'Cunt: A Declaration of Independence' - which I read in my 20s, didn't we all? - was an eloquent argument for reclaiming your feminine power like this. Ditch the pills and painkillers and embrace cycle tracking and raspberry-leaf tea. Make your own reusable pads with brightly patterned cloth. Taste the blood, make art with it. Learn to love your period.

Which is wonderful if it works for you. It doesn't for me - no matter how badly I wanted it to. Being period-free has been a real liberation for me, I can't even find the words to describe how much it's improved my quality of life to not be living in pain and dread from month to month. This is what works for me.  This is my choice. And surely that's what feminism should be about: ownership of our bodies and our choices, and recognising that there's not a single correct way to be a woman.

Back in the second-wave days of the feminist movement, there was a real emphasis on sharing medical knowledge and skills, and taking a self-help approach, from 'menstrual extraction', a technique for removing menstrual flow in one go, to herbal abortions and natural birthing.

I don't agree that trying to do these procedures without proper medical expertise and facilities is a good idea, and I don't share the mistrust of conventional medicine. But I liked the independent, self-determining spirit of it.

So maybe we don't even need branded and packaged solutions like Seasonale. Maybe we just need to educate ourselves about how the existing pills can be used, and take control of how we use them, instead of being told what we can and can't do. Yes there are risks, but we're big girls now. How about women decide for ourselves what risks are acceptable to us - after we've been given all the relevant information and medical advice, of course - and how many (if any) periods we want to have and when we want to have them. Periods aren't really a curse. But they are a choice.

(First published at The Huffington Post UK, 10th August 2014)


Post a Comment

<< Home