All women’s contraceptives are terrible

You want me to put that where?
You want me to put that where?
Image: Reuters/Rupak De Chowdhuri
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The first self-injectable contraceptive has just been announced in the UK. Women can now inject themselves from the comfort of their own home, but it still doesn’t detract from the point that the contraceptive injection in itself is not great. In fact, all women’s contraceptives are terrible.

The self-injectable contraceptive—known as the Sayana Press—provides 13 weeks of protection and is 99% effective. For those who may forget to take birth control pills every day, the injection can be a great alternative. That’s if you don’t mind a number of caveats.

In advanced studies, researchers found that while half of women remained within 2.2 kg (4.9 lb) of their initial body weight, 38% of women gained more than 2.3 kg in the first year. Sayana Press admits that “weight changes are common but unpredictable” and it has a lot of the same side effects as other contraceptive injections: headaches acne, tender breasts, changes in mood, and loss of sex drive.

These side effects are common in a lot of other contraceptives, including, but not limited to, the combined pill, the IUS (hormonal coil), and the contraceptive implant. A common piece of advice if you’re experiencing these side effects is to wait it out, and hope they disappear within the next three to six months. But, who on earth is happy to cope with six months of mood swings? One in three women, according to a survey conducted by The Telegraph.

The same survey found that more than a quarter of women didn’t know what hormonal contraception was doing to their body and 41% were only using a method of contraceptive because a doctor or nurse recommended it.

As a lot of the studies on hormonal contraceptives are almost exclusively based on epidemiology, where researchers observe patterns in populations rather than try to assess causal links, it’s hard to know which side effect is caused by a contraceptive. This makes it particularly difficult for a doctor to conclusively say whether the contraceptive a woman is using is the reason for headaches or loss of sex drive.

There is the option of a non-hormonal contraceptive. The female condom is 95% effective, if worn correctly, but it’s more expensive than its male counterpart and harder to find. A journalist who tried it said it was like “sticking a plastic bag” into her vagina. There’s also the IUD (non-hormonal copper coil), but it might come with the addition of heavier, more painful periods, cramping, and pain during sex.

Women are told to find the contraceptive that works best for them, but many are left navigating this minefield of side effects alone. While many women don’t have any issues with the contraceptives, why are some of us left with the choice of accepting these side effects or pregnancy?

Of course, it goes without saying that the birth-control pill is one of the most important advances in science and gender equality. It gave countless women the reproductive freedom that is essential to achieving our lifelong goals, but this freedom comes at a price.

And the issue of side effects is particularly important for women; even with the increasingly-popular coil, side effects were the main reason why women chose to remove it (pdf). The Sayana Press is an important step to improving this method of contraception, but science has a long way to go to better improve an essential part of women’s health.