T
he Pill has been called the
Madonna of medication for
good reason: it is an icon, is
known by just one name, and
is a symbol of sexual freedom.
It arrived just in time for the swinging
60s and caused massive social upheaval by
enabling women to explore their sexuality
without fear of an unwanted pregnancy.
“Everyone knows what the Pill is,” wrote
author Pearl Buck for Reader’s Digest in- “It is a small object – yet its potential
effect upon our society may be even more
devastating than a nuclear bomb.”
Instead, the Pill gave women the power
to control their reproductive health, play
the field before marrying (or not), pursue
higher education without interruption,
carve out careers and, ultimately, choose
their own adventures.
But almost 55 years on, many women are
having second thoughts about it amid
a growing awareness that one size does not
fit all when it comes to birth control.
“What suits one woman may be very
different to what suits another,” says Dr
Deborah Bateson, medical director and
director of clinical services at Family
Planning New South Wales (FPNSW).
“And what suits a woman when she is 18
may not suit her when she is 30 or 45.”
Dr Bateson says the arrival of new
contraception options – including new-
generation IUDs – plus increased
information online about the pros and cons
of different choices, are encouraging
women to question the status quo.
Meanwhile, high-tech period tracking
apps are fuelling a revival of some old-
school family planning tools such as
fertility awareness methods (FAM).
A new generation of health-savvy women
are signing up for fertility workshops and
e-courses to learn about their cycles
and are seeking birth control sans synthetic
hormones. Others seek alternative options
because they’re sick of the side effects. And
genetic factors (more difficult to detect
a generation ago), such as a family history
of certain cancers, are also being considered.
We’ve come a long way since the days
when ancient Egyptians used crocodile
dung pessaries and Indians fashioned
theirs from elephant dung. Legendary
lover Casanova used linen condoms and
advocated the use of half a squeezed lemon
as a cervical cap. The ancient Greeks
believed women should sneeze or jump
backwards seven times after sex. And the
six-sided wooden block inserted into the
vagina in Victorian times was later declared
an instrument of torture.
The Pill was the first medicine designed
to be taken daily by women who were not
sick. Depending on which one you take,
it uses varying doses of estrogen and
progestin (or just progestin) hormones to
stop you ovulating each month. It also
thickens cervical mucus, making it difficult
for sperm to swim through, and alters the
uterine lining so if an egg were released, it
would not develop.
Along with being 99 per cent reliable, it
may also ease PMS, slightly reduce your
risk of developing multiple sclerosis and
lower your risk of ovarian, endometrial
and colon cancers.
But the less happy
side effects range from
nausea, weight gain,
sore breasts, irregular
bleeding, low libido
and mood swings to
migraines, high blood
pressure and a slightly
increased risk of breast
cancer and blood clots.
Of course, millions of women have been
willing to take these risks for the sake of
convenience. According to FPNSW, oral
contraception is still the most common
birth control method for Australian
women at 27 to 34 per cent, followed by
condoms at 20 to 23 per cent, while
long-acting reversible methods (IUDS,
implants, rings and injectables) are used by
just 3.8 to 8.4 per cent.
But Dr Karen Coates, who has been an
integrative women’s health doctor for more
than 25 years, says her patients are now
asking more questions about birth control
options. “There are a lot of women who are
more educated about the Pill these days,”
Dr Coates says. “So young women are
coming in to discuss and explore
alternatives now. Thirty years ago there
was no option for reliable contraception
apart from the Pill. In the 80s and 90s it
was almost a rite of passage. Young girls
didn’t think too much about it and they
certainly didn’t consider any alternatives
such as the diaphragm, the injectable Depo-
Provera (effective for 12 to 14 weeks), the
Implanon rod and the NuvaRing.”
Dr Coates says hormonal IUDs (sold
under the Mirena brand in Australia) are
making a comeback because the new,
improved T-shaped implants no longer
trigger the excessive bleeding caused by
their predecessors and can be left in for five
years. “The new (hormonal) IUD is
impregnated with synthetic progesterone,
which can stop periods altogether,”
Dr Coates says.Meanwhile, the recent revival of Fertility
Awareness Methods suggests the future of
birth control may be a mix of retro practices
and modern technology.
FAM (once called the Billings ovulation
method) involves recording your basal
body temperature daily and observing your
cervical secretions to track fertility and
identify the fertile window each month.
In the past, the daily record-keeping
meant FAM best-suited proactive
personalities. But now there are apps such
as Kindara, Glow and Ovuline to help
women track their periods and fertility or
prevent pregnancy. To
make it even easier,
Kindara has released
the Wink, a wireless
oral thermometer,
which automatically
sends your temperature
via Bluetooth to your
iPhone. Once your
temperature has been
recorded, the app will
tell you how fertile you are on that day.
Traditional Chinese medicine
practitioner and fertility expert Dr Nat
Kringoudis has taught women how to
improve their hormonal health and boost
fertility – or avoid pregnancy – using
natural methods for more than five years at
her Melbourne clinic, the Pagoda Tree, as
well as via online e-courses and workshops.
Her Debunking Ovulation course is all
about cervical mucus, menstrual cycles and
natural contraception methods. “It’s two
hours of information to help women
understand their menstrual cycle,” she says.
In the beginning, Dr Kringoudis saw
mostly women wanting to fall pregnant.
But lately, she’s seeing more young women
keen to understand their cycle in order to
make informed decisions about birth
control. “If you actually understand it, you
will realise you can only fall pregnant
a couple of days a month,” she says.
Birth control aside, Dr Kringoudis says
she also sees many women begin taking
the Pill to manage the symptoms of
polycystic ovary syndrome (PCOS) and
other hormonal imbalances, which often
improve after they make a few simple diet
and lifestyle changes. “The Pill might give
you some short-term relief but long-term it
is not fixing the problem,” she says. “The
contraceptive pill is a form of contraception.
It was never designed to be a treatment
method. I’m not saying the Pill doesn’t work
... but you need to understand what it’s
doing to your body and then make a decision
about whether it’s right for you.” ■“THERE ARE A
LOT OF WOMEN
WHO ARE MORE
EDUCATED
ABOUT THE PILL
THESE DAYS”VOGUE.COM.AU – 12 5ART DIRECTION: DIJANA SAVOR PHOTOGRAPH: EDWARD URRUTIA