it is important to clarify a couple of things, before i begin.
- i have had anxiety (in one form or another, to alternating degrees of severity) since childhood. i am therefore unable to say, with complete certainty, to what degree the pill has contributed to my mental health issues. my opinion that the pill has negatively impacted my mental health has, however, been reinforced by numerous health professions - both mental and general practitioners - and, is also based upon the comparative state of my mental health between my years on the pill and the months since i’ve stopped taking it.
- let me explicitly state that i am not arguing a case against hormonal contraception. it is important for me to make clear that hormonal contraception was - quite literally - a lifesaver for me, for many years, in terms of the physical symptoms associated with my periods. the pill is wonderful for many people, and coming off it was not an easy decision for me, as the pros outweighed the cons for a very long time.
- just because you have a bad experience with one pill, doesn’t mean there isn’t one that’ll work for you on all levels. i have by no means exhausted my options, i just felt like i needed a break after my particularly bad experience with the last pill i tried. i wouldn’t rule out my going back on a different pill at some point - but, at the same time, people who suggest trying your hand at the pill lottery ‘until you find one that works’ are usually people that found this on the first, second, or even third, try. in reality, there are an almost endless number of hormonal contraceptives to try and, actually, the level of investment involved in doing your research, arranging a doctor’s appointment, picking a new option, giving your body time to adjust (usually suggested at about 3 months), constantly needing to evaluate how you’re reacting to it, the analysis that informs your decision about whether it’s right or wrong for you, and then needing to start the process all over again, is not something to be underestimated. navigating the minefield that is the contraceptive pill is not an easy, or quick, task - and prescribing the ‘keep going til you find The One’ course of action is often much easier said than done.
now, to business. here is a very brief* history of my love/hate affair with the pill.
*it is not brief.
- aged 15: got my period. Bad Times. like really, really bad times. after complaining about the pain to my mum i got what was essentially sympathy thinly masking a resounding ‘suck it up’. in her defence, as women we’ve probably all been on the receiving end of the nod of solidarity that says ‘aw yeah period pain what’s it like!’ when, in fact, for some among us it is literally life-ruining and completely debilitating, and we can only imagine the struggle.
- aged 16: eventually pipe up to the GP about my period pain. she is understandably aghast when i tell her it causes me to be unable to feel my legs. ‘you waited a year to come and mention this?!’. i sheepishly explain i thought that was what it was like for everyone.
- aged 17: by this point we have tried very strong painkillers, mefenemic acid, some-other-acid. none of it works. i bleed heavily for 7+ days. i feel like i might shit myself all the time. i have a hot water bottle attached to my body at every given moment i’m not at school. i sleep with a beach towel on top of my sheets because i regularly soak through sanitary protection and pyjama bottoms. the GP suggests we try the pill. microgynon. i vividly remember telling my mum this on the phone after my appointment, trying to deliver the news coolly and casually - with heart palpitations and clammy hands. [‘omg she’ll think i’m a massive slut’]. but, approximately 28 days later it became apparent that no-one’s opinion of my contraceptive-guzzling would ever make me give up the stuff. it was a miracle cure. a 5 day period and not a cramp to be found.
- aged 19: my love affair with microgynon is cut unexpectedly short. i go to collect my prescription and, with no warning, my paper bag does not contain the usual green pack, replaced instead with a neon pink that i was immediately very suspicious of. and rightly so. rigevidon made me raging and horrible and hungry all the time. but it was also still within the ‘settling-in’ period and i was also a teenager, so i went with it.
fast forward to age 25. it’s been 6 years. i’ve been in the same bad mood since 2011. i’m still hungry. my mental health’s in the bin. i’ve done my research. i’ve been involved in campaigns. i’ve decided the pill is to blame. i ~heroically~ decide to go pill-free from this day forth. a couple weeks later i get my period and immediately make an appointment to get a new prescription. it was as bad as i remembered. i had been at least 30% sure i was exaggerating, or maybe just misremembering. ALAS DEAR READER. the Bad Times were back. i tell the lovely wonderful ruth at boots chemist in glasgow central station (for real, if you are within a 50 miles radius please go see her) my issues and she sits with me for FORTY EARTH MINUTES, and actually listens to me. for those of you reading this who have the pleasure of a dedicated doctor dealing with your OBGYN needs, it may be hard to comprehend how we tend to do it in the uk. in my local surgery, there is an ever-changing pool of total strangers who i am randomly assigned based on who is free at the exact moment of my appointment, and who i then need to get up to scratch on my 25 years of health & wellbeing in approximately 48 seconds before i’m given a prescription and hoofed out the door. (i am the NHS’s number one fan, this is not ungratefulness, simply the reality of my local practice). chemist (and new best friend) ruth, however, listened to my concerns, appreciated that i had done a lot of research, and talked through with me the various options i had.
this next bit now requires a brief summary of how the contraceptive pill works. the most common type is the combined pill. this includes (but is by no means limited to): microgynon, rigevidon, cilest, yasmin. these pills contain two hormones. they are oestrogen and progesterone. there are many different varieties of these hormones and, on pill packs, you will see them listed as their specific names - for example, rigevidon’s oestrogen is called ethinylestradiol, and the progesterone is called levonorgestrel. the pill usually contains 150mg of progesterone and 30mg of oestrogen. sometimes, when women find themselves reacting badly to a pill, this can be narrowed down to one of the hormones. for this reason, some pills have different doses of each hormone. ruth the chemist thought that my issue was maybe with progesterone, and so she put me on a pill called loestrin 30. instead of 150mg of progesterone, it has 1.5mg (in this case called ‘norethisterone acetate’). this way, we would be able to narrow down the issue. if i got better, progesterone was potentially to blame; if i got worse, maybe oestrogen was the culprit and we’d have to try a different one to better prove the theory.
i got much, much worse. my high-level anxiety was gone, and was instead replaced by low-level anxiety - but only because i was so completely depressed that i didn't have the energy for it. i also had almost no period whatsoever. while, on paper, this is great and i was theoretically living the dream, in reality it didn’t quite pan out like that. my health OCD was through the roof. i was convinced i was pregnant ALL the time, even when i knew it physically wasn’t possible. (more on that another time maybe?). i persevered the best i could for the 3 month trial period. during one week in january, for the first time ever, i experienced depersonalisation. i was standing in the bathroom staring into the mirror trying to work out *how* i could work out if the reflection was really me or not, and i realised it wasn’t worth it. i was 2 pills away from finishing the 3 month course, so i think it’s fair to say i gave it a chance. it’s been 3 months since i finished taking the pill. you’ll need to come back for part 2 to find out what went down.
now, my pals, this might seem like a cheap marketing ploy to trick you into visiting this site once more, but in fact, i am just wholly incapable of writing anything efficiently and to the point. the sequel will be as to the point as possible. pinky swear. see you soon!