• Riviera Insider editorial

How safe is the pill? A discussion on the dangers of hormonal contraception

After a young woman from Antibes nearly died of a stroke this past February, we look at the side effects that are rarely discussed and Riviera Insider's Kimberley Mannion recalls her own close call.

Suffering a stroke at 22 was something the doctors couldn’t believe but it was the fate of Carla, a university student prescribed the contraceptive pill, like millions of other girls. After being gripped by sudden, severe symptoms including immobility in one hand and difficulty with speech, she fled home to her parent’s house on the Côte d'Azur. They took her to hospital in Antibes, where she was given paracetamol and told it was just a headache. But the results of an MRI were worrying - signs of a stroke on her brain.

Carla was immediately transferred to hospital in Monaco, where she would spend the next week. After a thorough medical review, doctors told her to throw out her packet of contraceptive pills and never take it again. Her story is not rare. She was one of over a thousand women to get in touch with Nice Matin after they called out for testimonies of similar experiences with the pill.

No one believes the most serious of these side effects could ever happen to them, but the reality is that they do happen to some. I was 17 when I suffered a pulmonary embolism four months after I began taking the pill. Had I not been with a friend who’s mom who is a doctor, I might not have survived it.

A daily routine

‘The pill’ is the most popular method of contraception worldwide. Millions of women rely on it every day. Now somewhat taken for granted, the pill was a revelation for women’s rights when created in the 1950s in the United States. Its lifetime has corresponded with years of enormous progress in women’s freedoms, financial indpendence and status in the world.

It would be ridiculous to suggest it hasn’t brought more good than bad - its development undoubtedly led to fewer unwanted pregnancies and more autonomy for women.

TIn fact, the pill is so popular now that it could almost be considered a right of passage for young women. Around 9 in 10 women in the UK take the contraceptive pill and about 4 in 10[i] women in France. It is so common, yet the conversation surrounding its side effects remains largely isolated to groups of girlfriends rather than large platforms.

Side effects

Practically everyone on the pill reports noticing some difference in their bodies. The most common of the ‘minor’ side effects include mood swings, migraines, irregular periods and weight gain, along with a myriad of others like headaches and breakouts. We could list about one hundred in total, according to Sylvain Tassy, a Nice- based gynaecologist/obstetrician, interviewed by Nice Matin.

Women who have taken the pill for many years, as is often the case, are often shocked to find when they eventually quit that things they had grown so accustomed to are not just part of their character, or something they just have to put up with, but rather were caused by the artificial hormones. It is not uncommon to find the pill actually alters you as a person, affecting your moods, reactions and libido.

Making the decision to come off the pill, especially when you have been dependent on it for a large part of your adult life, can be just as big a decision as that to begin taking it - often more so, as the implacations could life-changing. The difficulty adjusting to the imbalance of hormones and learning to feel comfortable with a new form of contraception is another part of the female experience little spoken about, but difficult for many.

At least 83 women in France die per year because of their contraception

A statistic[ii] which is so shocking because the pill is not something we think of as dangerous - in fact, we probably think of not taking it as more ‘dangerous’.

The reality is, the contraceptive pill is linked to several life-threatening side effects, mainly blood clots, which can lead to pulmonary embolisms in the lungs and deep vein thrombosis in the legs. These can cause heart-breaking stories of young women and girls suffering strokes.

According to journalist Sabrine Debusquat for Nice Matin, author of ‘I’m stopping the pill’, women under 30 who have taken the pill at least once in their life have a death rate three times higher than those who have not taken it.

But this is often little known. The doctor prescribing the medication usually runs over the side effects we most commonly think of, adding in the sombre caveat at the end that it can provoke blood clots—but the chances of that happening are minute, one in hundreds of thousands. That could never be you, your sister, friend or, cousin. The problem is, the 83 or so women who will lose their lives to these side effects this year, women with families and whole lives ahead of them, likely think the same.

Expanding the conversation

The ability to recognise side effects is the most important reason why we need to start having louder conversations about the pill. Many women, and particularly teenage girls, either do not understand that what they are feeling can be associated with their pill or they don’t want to talk about it because it is uncomfortable or is still considered taboo.

In my own case, I would not have connected the dots between unusual breathlessness during my dance classes and chest pain with starting the pill, had it not been that my best friend’s mum is a doctor and knew about my situation. She urged me to go to the doctor a few days after my symptoms began, and after many tests (and my first real hospital experience), the doctors got to the bottom of it and declared I had a blood clot on my lung.

Whilst the medics cannot prove outright that the cause of my ordeal was the pill, there is little other reasonable explanation for such an illness in an otherwise fit and healthy 17-year-old. I was told in no uncertain terms to stop taking the pills immediately, and never to take any form of hormonal contraception again, as my body clearly didn’t agree with it.

I was lucky that thanks to a swift diagnosis, I could easily be treated and was back to normal in no time. It is worrying, however, that many young women may dismiss symptoms as nothing, and their story may not end so well.

Whether physical symptoms like this or the mental health effects the change in hormones can cause, patients should be better informed on when to realise there is a problem, and not to dismiss blod clot symptoms as just ‘in their head.’ There should also be more discussion of other options so women don't feel they have to stay stuck in a situation that is not working for them.

What’s the alternative

The pill being portrayed as unquestionably the best form of contraception is one of the main criticisms it comes under. This goes hand-in-hand with the hushed discussion of side effects, limiting the scope for women to question whether the pill is really for them or if they may be better suited to something else.

The range of contraception on the market is wide, but most involve artificial hormones which cause some of the same side effects as the pill, most notably, unstable moods. On the other hand, non-hormonal methods are generally less effective. And so, women must decide between the level of risk they want to take and their day-to-day health.

Trials into a male contraceptive injection concluded an almost perfect efficacy rate, but trials were halted[iii] after complaints of negative side effects reported. These included depression, acne and mood disorders; all of which have been tolerated by women on contraception for decades.

The future

However imperfect the pill may be, it remains a necessity for women across the world and the side effects are considered a normal part of life for most women.

What is needed then, is a greater awareness and open discussion of the side effects in public platforms - so women can enjoy its benefits which they have a right to, without feeling like they have to be a slave to one pill for years of their life at the expense of their freedom. And perhaps with more open conversation and a refusal to 'put up' with side effects like the men in the trials, a better solution can found.

-Kimberley Mannion

Sources: [i] [ii] From, article 630471 [iii]

*This article originally appeared in the April-June 2021 issue.

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