• The Pill doesn't work for everyone, writes Madeleine Ryan. (PhotoAlto/Getty Images)
Contraception needs to take women's overall wellbeing into account, not just efficacy statistics.
Madeleine Ryan

19 Dec 2017 - 2:15 PM  UPDATED 21 Dec 2017 - 11:12 AM

Until relatively recently, the negative effects of hormonal contraceptive methods were little discussed.

Behind all the numbers endorsing their effectiveness – “99 per cent” and “99.9 per cent” – the toll of their efficacy has rarely been questioned. Yet these prescription medications are now being linked to higher rates of depression, blood clotting and digestive problems, with side effects including vaginal haemorrhages, uterus perforations, ectopic pregnancy and even unwanted pregnancy - none of which are really “side effects” because they hardly feel like they’re “on the side” when you’re experiencing them.

It took me 10 years to realise that the constant state of tension and anxiety I grappled with might be connected to using the Pill; and it never occurred to me that the Irritable bowel syndrome diagnosis I received could have its roots in my altered hormonal state. No doctor suggested that this might be the case, nor did they offer alternative contraceptive methods. So choosing to come off hormonal ones meant that I had to do some serious research, which is a bit out of fashion in a world where we are encouraged to solve our problems quickly, and with pills.

It turned out to be well worth the effort, though. A sense of empowerment and mental, emotional and physical health might not meet the requirements of a pharmaceutical company’s testing, a GP’s questionnaire, or a researcher’s graph, but it has certainly met the requirements of my body and my life.

My partner and I now have a much healthier dialogue around contraception - it isn’t something that I’m expected to be able to manage on my own.

I’m in a long-term, sexually active relationship and after almost two years off the pill, my hormonal cycle has regulated, tension and anxiety pass much more easily, as do my bowel movements, and I have avoided pregnancy. My partner and I now have a much healthier dialogue around contraception - it isn’t something that I’m expected to be able to manage on my own. And, if I were single, I would hope to cultivate that same sense of mutual responsibility.

Books and websites have helped us along the way, including Miranda Gray’s The Optimized Woman and Jane Knight’s The Complete Guide to Fertility Awareness because The Fertility Awareness Method (FAM) is different from The Rhythm Method.

Whilst The Rhythm Method is based on the idea that a woman’s past cycles indicate her current and future cycles, FAM does not make these kinds of assumptions. FAM involves getting to know cervical positions and their relationship to pre-ovulation, ovulation, post-ovulation and menstruation as well as the different colours, textures and meanings of cervical fluid.

It encourages taking your temperature reading each day (also known as the Symptothermal Method), but I don’t do this because I find it too finicky.

The apps that accompanied various temperature-tracking devices proved unreliable, and the expectation that I could record my temperature at the same time, every morning, after waking up in the exact same position that I woke up in the previous morning, proved to be unrealistic, and inconvenient.

I prefer to use digital ovulation tests, which you can get at the chemist, and I’m also interested in trying saliva-based ones because they work out to be cheaper.

Through FAM, we learned that the height of ovulation lasts 12-48 hours so it’s best not to have sperm in my system for 3-5 days leading up to that. We avoid sex for around one week per cycle and use natural spermicide and a fem cap – which is like a diaphragm, except it stays in longer – if we’re still feeling unsure about what’s happening when.

My period is no longer a reason not to have sex...

My period is no longer a reason not to have sex because when I came off the pill, period pain increased, and I found that orgasming helped to alleviate it - as did seeing a Chinese medicine practitioner.

No one contraceptive method is going to work for every woman because each of us is an ecosystem in and of ourselves.

The job that we all share is to ensure that we make informed and consensual choices, so whilst celebrating the “99 per cent” and “99.9 per cent” of hormonal contraceptive methods - we must always make sure that we’re getting 100 per cent of what we want.


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