Second Class Citizens: Women & the Healthcare System
When the pill was first marketed in the 1960s, it was the dawn of the sexual revolution. Women everywhere celebrated the hard fought for right to bodily autonomy - the liberation of female sexuality had finally begun.
At the beginning of 2018, there are more than 140 million women using some form of hormonal contraception worldwide; sexual liberation on a global scale. But for the past six months, I’ve been asking myself about the cost of this sexual liberation to our mental and physical health. Are we, as women, really second class citizens in our own healthcare system?
Me, Myself and my Healthcare System
You name a pill, I’ve been on it.
Microlite, Ovranette, Yasminelle, Yasmin, Dianette, Cerazette…
I started taking the pill at 17, sort of for irregular periods but mostly because I wanted to. My first go at it was uneventful, no major side effects that I can remember, but the dosage wasn’t strong enough to regulate my cycle so I switched.
At the beginning of my second year at college, my anxiety was crippling. I sobbed irrational, rage-filled tears night after night and drifted through lectures and work in a haze as if a cloud hung inside my head, living in a perpetual state of distress. My skin broke out, my confidence hit the floor and I couldn’t bring myself to speak to anyone about it because I honestly believed I was losing my mind. During this mental turmoil, I was taking the combined pill Ovranette. And when I stopped, all of this stopped too.
While taking Yasmin, I had panic attacks, flew into terrible, inexplicable moods and became so paranoid that one evening I convinced myself it was not my boyfriend texting me, it was a stranger pretending to be him. On Yasminelle, I was hyper-anxious, always tired and had constant pains in my legs.
I kept switching, kept trying something different, told time and again that I just hadn’t found the right one for me yet. The only common denominator between each pill was that a few weeks after I stopped taking it, I went right back to the normal me.
After many years and many prescriptions, multiple medical opinions advised me that unfortunately I was “just one of those girls who can’t take the pill”. I was prescribed Cerazette instead, a progesterone only substitute for the combined form.
Great in theory, except that in reality, Cerazette gave me all the symptoms of pregnancy (all day nausea, generalised fatigue, migraines) and worst of all, cystic acne. Cystic acne is like common acne on acid – your skin becomes stretched over angry, agonising lumps while your jawline constantly throbs with the pain. I felt as if everyone was staring at me, thinking I was dirty – teenagers get acne, not 24 year olds! Every morning, I woke up with cysts in worse places.
I spent hundreds of euro on top of the range skin care, lotions, potions and supplements, but nothing worked. In fact my face was getting more swollen and sore by the day, so I started to read more about the long term effects of hormonal imbalances and what this was doing to my body on the inside as well out. I traced back my seven year journey, pill after pill, and was confronted with the fact that all my health issues, the majority of them mental, were written in plain English on the information leaflets inside each pill:
Brain fog (check)
Difficulty concentrating (check)
Anxiety (triple check)
Increased appetite (check)
Cystic acne (Cerazette I’m specifically looking at you)
One Tuesday morning I ceremoniously dumped four months’ worth of Cerazette in the bin, went to the pharmacy for advice and was told to wait about six to eight weeks for the nausea, migraines and acne to subside.
Almost six weeks to the day, no vomiting, a lot fewer headaches and no more cysts (just a few purple scars as a reminder of my last ever dance with added hormones).
Women = Men (?)
None of this is to say that you shouldn’t continue to use your chosen form of contraception - always, always protect yourself, just find the option that is right for you. I have many close friends who have taken the pill religiously for years and some who are perfectly content with having an implant in their arm for three years at a time. It goes without saying that there are many women the world over who have taken the pill on a long term basis to little or no obvious side effect; more power to you, in some ways I wish I could do that too.
But since I started looking more deeply into this subject, I’ve spoken to a multitude of girls who have had horrific experiences with hormonal contraception just like me. Often, it’s only with hindsight that we can look back at our physical or mental health issues and say actually, this was all written in the side effect section on the back of my pill packet.
Whether through the pill, the bar, the injection, the patch or an IUD, we as women are left with little choice but to absorb (let’s face it) unnatural levels of foreign hormones into our bodies every day, just to retain our right to bodily integrity – to choose how and when we have children. Women have shouldered the burden of so many things for so very long, and the stark reality is that we continue to bear the responsibility of reproductive protection far more than men do. We have fought for the right to vote; the right to continue working after marriage; the right to equal standing in a court of law – and emerged victorious. We are fighting (and slowly winning) the battle against the gender pay gap. So why should we continue to accept the status quo on contraception when there are so many indications that it is harming women as well as doing them good? Why should we continue to consume chemicals every day when even the producers of these tablets acknowledge the damaging side effects?
I support all contraception in principle because the right to determine what a woman does with her body and when is nobody’s choice but her own. Yet we must address the fact that the hormonal options offered to us in 2018 simply aren’t good enough. I firmly believe that if it were men who endured menstruation, pregnancy and childbirth, the shortcomings and associated side effects of contraception would have been rectified decades ago. The proof is in front of us.
Second Class Citizens
In October 2016, 350 men were injected with the hormones progesterone (contained in female contraceptives) and testosterone during a clinical trial. The results were a resounding success – the male injection was found to be practically on par with the reliability of the female pill.
But something terrible happened. Twenty of the men dropped out of the study due to alarming side effects, such as depression, anxiety, acne and significant changes in sex drive - carbon copies of the common as muck, socially acceptable symptoms experienced by women all around the world who take hormonal contraception day in, day out. We have been ‘a few years away’ from male contraception for five decades. The side effects regarded as too dangerous, too disturbing for men are taken as given when a woman is on the receiving end.
We live in a world of often unconscious double standards between the sexes. It’s undeniable that we are different, men and women. We are different, but our differences do not make us unequal, and should not mean that we accept inequality in our society or in our healthcare system.
I’m starting 2018 hormone free, and if you want to look into some (admittedly limited) non-hormonal contraceptive options too, try the links at the bottom of this page or feel free to send me a message!
Last month, the Merriam Webster dictionary named ‘feminism’ its Word of the Year 2017. The definition of the word is ‘the advocacy of women’s rights based on outright equality of the sexes’. I hope that by 2027, the healthcare system will uphold the principles of that word to give us more equitable choice in our contraception and more support for women in reproductive healthcare full stop. Equal rights and equal treatment for men, women and everything in between.