This captures the true agony- to be on the Pill (hormonal birth control). I struggled mightily with this question in my 30s and early 40’s, knowing full well the horrible effects on my mood but the benefits to having a less intense, less painful and predictable cycle. I was on yaz, safyral, and lo estrin. Tried to go off, sometimes months at a time but because of my endocrine disorder (PCOS) felt I had no choice. Things have leveled out in my mid 40’s...my body resoundingly rejected the pills and their effects and I gradually went off over a 4 month period. I feel like a refugee.
2
Sindha, thank you so much for sharing your experiences with this! I myself went through decades of problems surrounding my own body's hormonal problems.
I had difficult menses from the time I started as a young child, but was told that it was normal and that women don't make a fuss about such stuff. I stayed away from the pill because I was sure that it would be a poisonous adventure. I had a tubal ligation at 25 after the birth of my son so that I would not have to take pills...until I started hemorrhaging regularly during periods, and nothing would stop it.
For the next seven years, I never knew if I would have a crash and burn bleed and end up in the ER. Finally, a doctor took pity on me and gave me the hysterectomy I was praying for.
My hormone issues have gone on for most of my life. Without meds, I can still deal. I have had menopausal hot flashes for the past 30 years. They may last the rest of my life, but I can deal with how my body is...I can't deal with drugs that dispensing docs don't even know the mechanism of how they work.
I, too, went through an emotional roller coaster for years,
2
The shameful truth is that there is class of compounds called "antiprogesterones" that have been shown in pilot studies to work miracles at low doses for endometriosis and uterine fibroids. Antiprogesterones have been made off limits to women because they are similar to the "abortion pill," mifepristone. Mifepristone is an antiprogesterone. The "right to birthers" have locked up antiprogesterones from commercial development, so no women can access it for other purposes --- such as disabling symptoms of endometriosis or uterine fibroids. The policy also hurts men, because this class of drugs have been shown to be effective for prostate cancer, oligodendrogliomas (benign brain tumors), and psychotic depression. Instead, women are compelled to suffer the side-effects of birth control pills, or subject themselves to mutilating surgeries. Misogynistic medicine. Not even the ob/gyns complain, because they're making money doing the surgeries, and office visits ---- whereas these antiprogesterones have been shown to be effective at extremely low doses with few side-effects. But just try to get some! They are in production in large quantities in Chinese pharmaceutical plants, but they are locked up in the distribution channels all over the world. For abortion, one needs a much higher dosage (100-200 mg); for endometriosis, fibroids -- 5-25mg daily.
6
When I was on hormonal contraceptives in my late teens, I was a crazed lunatic. Fine one moment, swinging to crazed jealousy and explosively angry the next moment. The Pill played harshly on my emotional state. I hated it. I was on the Pill for about three years, then just quit. My lustrous long thick hair fell out. I thought I was going bald. Coupled with the crazy mood swings and the embarrassing hair loss, I realized that hormonal contraceptives are absolutely not for me. I've never used them again as a sexually active adult. To me tinkering with your hormones with pills puts your body and mind out of balance. While I don't know much about endometriosis, I hope the author of the article finds something to alleviate her pain.
3
Endo sufferer since age 14 too. Not diagnosed until I was 29 and infertile. My doctor told me diagnostic laparoscopy was the only way to confirm endo. While he was doing the lap, he cauterized and removed all of the lesions he could see. This was minimally invasive surgery--had it on a Thursday, back at work on Monday. While my fertility took another couple of years to regain, the pain from even heavy periods was dialed back from a 8-9 each month to a 2-3. Went on to have two heathy kids--one with fertility treatments and the second one without. Later the endo turned into the wall of my uterus and I chose to have a laparoscopic hysterectomy. The pain of recovering from childbirth and a hysterectomy was less than the pain of monthly endo that I endured from age 14-29. If anyone out there is suffering from suspected endo that has not been confirmed, I suggest the confirmatory lap with removal if BCP's don't work within a year or so. Had I had a great doc when I was younger, I might have preserved my fertility and not had to spend thousands of dollars and endless heartache trying to get pregnant.
3
My periods started age 12 and they were heavy and painful from the get-go because... they were heavy and painful. I appreciate doctors who are passionate about solving problems, but as a systems engineer I can only shake my head and roll my eyes at descriptions of inadequate and faulty troubleshooting, especially when it involves a child's health.
2
Midwest gynecologist here.
Sadly, this is the price that women must pay, and have been paying, for decades in order to enjoy sex without fearing pregnancy. There are non-hormonal options, but these would offer no relief for sufferers of gynecologic diseases such as endometriosis, and most (excepting the copper IUD) are not terribly reliable.
What makes my stomach churn is that women are EXPECTED to tolerate the side effects as the price of admission for freely expressing their sexuality. A contraceptive option for men is instantly discarded for fear of side effects, and so men are free to lay the burden of contraception on their female partners, as they have done since time immemorial.
18
I see a lot of people here concerned about her (mis)diagnosed endometriosis. This is beyond the point of the article. The author's point, for those who also watched the video, is that women who choose to or must take birth control should be able to have better options at this point. Furthermore, when being presented to one, thoroughly go over the possible side effects.
I have been formally diagnosed with endometriosis at the age of 28 after struggling for years and years with severe cramping and long periods (8+ days). Three years ago I was also diagnosed with POS while at a fertility testing.
For some of us, the use of birth control is not an option or a decision. Regardless, all of us should have access to quality medication, at a decent price with detailed explanation of what would happen as consequences.
4
I must add that hormonal therapy helped me with menopause also. I went through an early meopause at age 43 - 44. "Prempro" stopped the nausea and high temperatures I did not have time for at work. Prempro balanced my body. I took it for a couple years until I did not need it anymore. Perhaps 11 is too young to shut down a whole system such as the reproductive system in the body, especially when it is just starting out.
I can empathize. Endometriosis was such severe pain for me each month it was embarrassing. However, I think cures for the once monthly menstrual pain from the system's processing should be addressed, instead of just shutting the bodily function entirely. That is strong action to take. The new system might need to function and as it does, it activates healthy signals for the brain; release of endorphins and other anti depressants.
2
I am a physician assistant who has practiced Ob-Gyn for over 25 years. We don’t know what diagnostic criteria were used to determine that the author has endometriosis. While there are physical exam findings that may suggest this diagnosis, certainly it is unusual to see endometriosis in such a young patient. Unfortunately, other than surgical destruction of endometriotic lesions or of resultant adhesions or other procedures, the other management consists of hormonal therapy: combination oral contraceptives, depot medroxyprogesterone (Depo-Provera), levonorgestrel IUDs, leuprolide, and danazol. I will also say that it is unusual to see such severe psychiatric side effects to estradiol and progestins. I hope the author seeks treatment from an expert in management of endometriosis and consultation from a psychiatrist, and that her conditions improve.
6
Depression symptoms are associated with rising levels of pro-inflammatory cytokines iL-1, IL-6 and CRP. During the part of the menstrual cycle when estrogen is high, IL-1 and IL-6 are suppressed. Not surprisingly, the other side of the cycle can bring on depression for women that are sensitive to hormonal and cytokine fluctuations.
Psychiatric symptoms that vary with every (or every other) cycle are not unusual with women who suffer from them. Genetic abnormalities and stealth infections can make matters that much more severe. It should not come as a surprise that exogenous sources of the hormones that drive the menstrual cycle can make patients manic or depressed. If you visit support groups for such people and ask about the correlation of menstruation and psychiatric symptoms, you will likely hear about some common patterns. I did. It helped me figure out how to help my partner overcome her symptoms. Cytokines are key.
2
As a follow up to my own post, I wish to share that many cytokines can be remodulated with herbs that have a much more modest side effect profile than exogenous hormones and most patented drugs. If your reaction to the notion of using herbs to treat serious physical and psychiatric symptoms is an eye roll and snicker, consider that I had the same reaction before doing extensive reading of medical and scientific research and witnessing dramatic, positive results in my partner who, due to unique genetics and a decades long Lyme disease infection that reached her brain, had severe reactions to most mainstream remedies.
I suspect that many of the women who respond to hormonal birth control with psychiatric symptoms have other genetic, infection, and exposure conditions pushing them in that direction. The extra hormones add a push, or remove a restraint, on cytokines that promote changes in metabolism, mood, and inflammation.
Of the cytokines mentioned above, IL-6 is the most important. It influences temperature regulation, brain fog, central and peripheral nervous systems, and MS like symptoms, by promoting "microglial activation" and deficits in the hippocampus. Red sage, "scute root," and kudzu root can suppress IL-6. Note that you need IL-6 during your period, so don't overdo it then.
"Seed cycling," cramp bark, and vitex can also help regulate menstrual cycles and symptoms. Check for thyroid and adrenal problems. Be curious, research, go slowly, and listen to your body.
5
I wonder if the writer had a definitive diagnosis of endometriosis, since she doesn't mention laparoscipy (and was very young for it to begin). Here are various statements from the internet about how endometriosis can be diagnosed:
"The only definitive test to confirm a diagnosis of endometriosis is through laparoscopy."
• "Unfortunately, many endometriosis patients are misdiagnosed, often multiple times, leading to unnecessary and inappropriate treatment".
• "There is no test for endometriosis, meaning patients cannot have their blood, urine, or saliva tested to confirm the disease. The only way to verify endometriosis is to undergo a diagnostic laparoscopy with pathology confirmation of biopsy specimens."
"... to be certain you have endometriosis, your doctor may refer you to a surgeon to look inside your abdomen for signs of endometriosis using a surgical procedure called laparoscopy."
"While you're under general anesthesia, your surgeon makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus."
"Unfortunately, neither the symptoms nor the physical examinations can be relied upon to conclusively establish the diagnosis of endometriosis. Imaging studies, such as ultrasound, can be helpful...but they cannot reliably diagnose endometriosis. For an accurate diagnosis, a direct visual inspection inside of the pelvis and abdomen, as well as tissue biopsy of the implants are necessary."
Wondering if the author or anyone has had a definitive diagnosis, in the case of endometriosis, is largely unnecessary for many people. In fact, surgery-to-diagnose is not something many doctors may suggest. (Unless the person wishes to find a more permanent solution to their pain as shown via peach in the end of the video.) In my own experiences and in reading about endometriosis it seems that surgery is: rare these days, recommended on a case by case basis and primarily used when also treating the disease via removal surgery.
"Laparoscopic surgery is the only definitive way to diagnose endometriosis, and In most cases the disease can be diagnosed and treated in the same procedure." - endometriosis.org
It might be helpful to consider that someone would rather not undergo a very invasive surgery resulting in no positive outcome which just confirms a lifetime of pain.
(I rely on "endometriosis.org" most of the time because it seems to be accessible and accurate. It dispels many of these myths including the very clear faults in the study which has suggested endometriosis is more common in older women and unlikely in young women. This is an age old idea which came about after a study of tested individuals with endometriosis in the 70's. They only tested women in their 30's- 40's and later -20's. That would explain the supposed gap in the information!)
1
This story makes me so sad. If only she had been to a NaPro Dr instead of trying all these birth control methods that obviously effected her hormones negatively! Catching Endo that young gave her a chance at really addressing it the way NaPro Dr's do. Women's lives have been saved & their endo for all intents and purposes cured using NaPro Technology. Those who are on the pill for health reasons like a really heavy, long & painful period are most likely making the situation worse for them because the pill is only masking your symptoms & never addresses the root cause of your problems. You may be on BC for years thinking it's fixing you but it's only been keeping you from realizing you may have cysts that now have grown so big you may be permanently infertile. So many women are unknowingly going down this route because their doctors don't know NaPro. I'm in a network of thousands of women with PCOS & Endo AND the NaPro doctors in one group all in agreement that NaPro has helped them way more than BC ever did. NaPro technology uses Creighton method NFP & works with your body (instead of against it as BC does) as a diagnostic tool to help treat these underlying issues. You can find a doctor in your state that can diagnose & treat these issues at fertilitycare.org.
As a whole though, since the pill is the "easy answer" for Dr's & the gold calf of the pharmaceutical industry, it ultimately shortchanges women by halting necessary research into what can actually cure these problems.
3
In 2000 Phytonics introduced XPL7- a safe no hormone no side effects natural plants based contraceptive which has no daily regimen, use only when needed before or after intercourse. Based on proven Nobel Prize winning work by the Swedish scientist Sune Bergstrom on prostaglandins. Used by thousands of women worldwide including nursing mothers who do not want to feed hormones to their new born infants. Unfortunately it can never overcome the hype of the Big Pharma propaganda machine promoting the hormone based Pill. Thanks to NY Times for bringing to light the quiet suffering of millions of women.
1
I'm not a health care professional, but I wonder how the doctor could definitively diagnose endometriosis at such a young age, without surgery. Maybe the painful periods had another cause. Sometimes teenage menstrual cramps go away in one, two or few years.
Maybe it would have been possible to just treat the symptom of pain (by staying home, resting, heat, etc.) and not get onto a merry-go-round of treatments that may become the cause--rather than the solution--of ongoing problems.
1
Please face the reality. Birth control is the only medical intervention given to purposefully induce a pathology for the sake of a pathology. It is the cause of sociological behaviors that are the cause of the pandemic of venereal disease and forces men and women into behaviors that they often would rather avoid. I cannot count the personal friends why have suffered serious debilitating illness because of birth control.
I think perhaps it is time we consider returning to a more natural kind of human behavior.
Some of the experiments done into the '1960's and beyond were horribly unethical and paid for by US tax dollars. One project that I am aware of that ended in the early 1960's was nothing less than an act of attempted racial genocide, and was also paid for by US tax dollars.
1
Dear GB,
I'm interested in what you mean when you say "it's time to return to a more natural kind of human behavior ".
What could that be?
2
You will have to think about that one. We live in a very unnatural world and have become accustomed to a kind of madness. It takes courage and intelligence to rise above it. We don't even know what natural means anymore for a human being. That is exceptionally sad for something that should be self-evident.
After watching the film, I wonder if your diagnosis is correct. You say the pain was present during your very first period. This does not indicate endometriosis, because endo develops from a failure of all the sloughed-off endometrial cells to exit the body properly during menstruation. The cells flow back into the body, outside the uterus, implant themselves in other tissues, and begin to grow. This process takes time. Therefore, you must have experienced at least one previous menstrual cycle to develop the condition, and it is unlikely (but not impossible) that such immense pain would start at the very early stages of endo growth.
Have you been evaluated for polycystic ovaries? PCOS? The symptoms can certainly be like what you experience, and it is much more likely than endometriosis to be present immediately at the onset of menstruation in puberty.
3
You present only one of three theories (in this case, Sampson’s theory) about the etiology of endometriosis. None of them adequately explains how this condition develops.
1
Dear Sindha, I wonder if anyone has mentioned, some women report that they have a bad experience with generic YAZ variety, compared to good experience with non-generic. If the formulations are not identical, the difference might be enough to color your experience. One woman I know is very sensitive to the difference and cannot use generic, but is completely happy with non-generic; and she complained that her insurance wouldn’t approve non-generic YAZ without special exception. Anyway, excellent video!
1
"...the pharmaceutical industry failing to inform women about and protect them from the side effects of hormonal contraceptives."
"A 13-year Danish study of over a million women between the ages of 15 and 34 found that users of [estrogen+progestin pills] had a 40 percent increased risk of depression after six months. Progestin-only pills were shown to more than double the risk, and the levonorgestrel IUD tripled the risk."
over a million women: the pharmaceutical industry is trying to inform men and women about the side effects from hormonal contraceptives.
...
"In my bathroom cabinet sat...Lo Loestrin, one of the lowest-dose hormonal contraceptives available."
a quick web search shows that: "Women with a history of depression should be carefully observed and Lo Loestrin Fe discontinued if depression recurs to a serious degree." other possible side effects could occur.
1
The Mirena (hormonal IUD) evened out my moods. We're all different.
I wonder if the author has considered endometrial ablation for her endometriosis.
1
Endometrial ablation is only effective for endometrial disease. By definition, endometriosis involves ectopic deposition of endometrial tissue.
2
As a teen in 1993, I was recovering from anorexia and not menstruating. Doc's solution? Put a 13 year old on birth control to get her period started. This sent my body into a state of shock - and my mind into an absolute frenzy. While rabidly Catholic uncle started emailing me photographs of aborted fetuses (who knows how he found out I was on the pill and what fetuses had to do with it), my doctor encouraged me to "just give it some time."
After a year, I threw the pills in the garbage and politely declined hormonal birth control whenever a well-meaning gyn would bring it up as an option.
Cut to 2007 - I'm in a serious, monogamous relationship and thought that there had been progress in bc chemistry. I ask my (different, new) MD about options. She basically said little had changed since 1993 and that as someone who had such a negative reaction as a young person, I would likely have a similar experience as an adult. She recommended a class, "Taking Control of Your Fertility"- which was exceptional and a wonderful opportunity to become more in tune with my body.
Obviously, this is not an elegant solution for those seeking hormonal bc for health issues rather than fertility. Most MD's operate inside a paradigm that offers only one way to look at the body. Clearly, little research has been done to work on contraception that has fewer side effects. Women deserve better.
5
Bless you, thank you, YES, this is so so important. I relate to every word of it. And these mood problems connected to hormonal changes (both endogenous and exogenous) are not unique to endometriosis sufferers. I have all of them and no endometriosis (and only mild cramps). A thousand times more research is needed. It's shocking how little the problems with hormonal birth control are discussed. Many women just eventually figure out for themselves that it's intolerable. (And again, many women don't have the same side effects-- but way too many DO.)
5
For those seeking support for period problems (i.e. not for contraceptive reasons), I strongly recommend Lara Briden's book "Natural Period Repair". Hormonal medications are not the only solutions available, nor necessarily the best option for many women. Do not be pushed to think pills are the only answer.
2
Copper IUD?
2
Copper IUDs make your periods heavier. It's the hormonal ones that lighten or stop the period because of the hormones.
2
If she’s on birth control to lessen/get rid of her periods, a copper iud won’t work. They make periods heavier and cramps more painful.
1
Can cause more, and heavier, bleeding. Not a good option for her.
1
The message to me is know your body and be aware of how your body reacts. I went on BC for the same condition at 21 40 years ago and it was the difference between being non functional and miserable and functional and thriving. My mother who was an RN chose, knowing all the risks, decided to go on hormone therapy during menopause because she was so erratic and miserable. Again the best decision for her.
I just wish that the treatments for endometriosis were further along as the treatment plan seems to be similar to my own all those years ago.
4
Thank you for writing this piece. As a fellow endometriosis sufferer, I can truly empathize. Birth control pills prevented further damage and controlled the endo pain well, but I suffered from terrible migraines, and eventually had to stop taking them due to thrombosis. Although ibuprofen and acetaminophen failed to put a dent in my pain regardless of the dose, I found naproxen sodium to be extremely effective in controlling my pain and allowing me to remain functional. Just thought I would share the tip and send my very best wishes for better health.
4
Thank you so much for writing this. Birth control pills gave me severe migraine headaches, left me feeling depressed and decimated my sex drive. I feel like doctors have always dismissed my complaints about the pill. I once had a Dr plead with me to try the Nuva ring right after I had gone off of a low dose pill that had caused me to have major migraines almost daily. I took the free sample just to get her off my back and then changed doctors.
I have been off the pill for ten years now and could not be happier.
5
Me too. Tried the pill twice in my twenties and it made me emotional and unhappy. My doctor told me I was imagining it.
7
Same here. Couldn't do the pill, couldn't last a week on the Ring. Thank you for speaking up.
6
This article has left me confused. Is it about the lack of good treatment for endometriosis or terrible side effects of hormonal birth control? Seems to me the article should have talked more about endometriosis. Hormonal birth control is interesting and important too, but these two topics are unfortunately scrambled here.
8
More than 10% of the comments to this article are responses to this one blithe dismissal, by a woman no less, of one of the potentially lethal side effects of hormone pills.
What struck me was that clinical trials for men's contraception were halted when a mere 3%...that is THREE PERCENT of the men experienced these symptoms. How Victorian to believe that depression is just a woman's natural lot in life. There is little profit for the pharmaceutical industry in treating endometriosis, so we have a long wait ahead of us. Meanwhile, corporations, who are also people, have the "religious" prerogative to select which contraception their employees may take when trying to treat this condition. *sigh*.
13
I'm sadly the other way and apparently my sister was too. She suffered from PMDD before it was known to be a thing. Essentially your menstrual cycle makes you crazy and no, I don't mean regular PMS. She committed suicide in the end. About a year ago, I decided to quit birth control because I didn't need it after all. Surgically sterile. After 6 months, I started to feel progressively worse. I was essentially useless for two weeks of every month. I had delusions, massive anxiety, crushing depressing and so much anger. It came to head when the first suicidal thoughts came filtering through. Then it clicked and I realized I had a tiny glimpse of what my sister had lived with and no one would listen to her. I trucked myself over to my GP and laid it out. She agreed to try and see if the bc helped. Thankfully it did and I am 100% better. Feel like myself again. Hormones are tricky devils.
11
It's as if the birth control pill is the ultimate gateway drug! How convenient that women start the pill in their teens.
The only time I ever had suicidal thoughts was thanks to the pill. After that I stopped using the pill ... the good news is the whole experience made me question all prescription medication and I try to deal with stress and pain without enriching Pharma shareholders.
Since the author is in San Francisco, I'm surprised she didn't try marijuana for her pain. Several of my SF friends have tried this and they say it works.
5
Again, women need to be believed and not brushed under the rug. Medical science needs to focus more on women's health.
11
I read Women and the Crisis in Sex Hormones by Barbara Seaman and For Her Own Good by Barbara Ehrenreich and Deirdre English in the late 1970s and they permanently altered my attitude toward "medical experts". I still want no part of them.
4
I think medical experts can be useful if one bears in mind that they are (or may be) experts in a given technical niche, not experts in one's own body and its current state. Experts can clue us into conditions and treatments worthy of examination.
However, we are all unique and it is up to each of us to learn about our own genetics, biochemistry, disease and exposure history, metabolism, symptoms, and patterns. Even the best, most personable doctor cannot be expected to be an expert in the details of all of those considerations, so we must fill in the blanks between what they know to be true for most people and what is true about ourselves, then educate our healthcare professionals about our uniqueness.
Back to experts and the cautions of the authors you mention, it is true that many of the most well publicized "experts" are selling one great "truth" and denying all evidence to the contrary. Just being aware of that is enough to recognize the dangerous "experts" instead of over relying on them. But there are medical experts who present important small truths and acknowledge that there are exceptions and limitations to what they have learned. Those are the experts worth following and continuing to learn from.
Required reading for all men. Period.
5
Thank you for airing this. Hormonal BC pills made me absolutely mental. Doctor after doctor encouraged me to try this low dose one or another low dose one, and OH look, we have a new super low dose one! They were all equally awful. Then my doctors looked at me disapprovingly when I complained about side effects, as if I were imagining them ("none of my other patients have any problems..."). For this & many other reasons that have come from years of experience, I take what my doctors tell me with a grain of salt.
I thought it was just me, until I brought up this topic with friends & family...turns out about 1/2 of the women I know also won't take BC pills because it either makes them depressed or feel like their on an emotional roller coastal. I threw my pills out & am never looking back. Women have enough pain, suffering, & inconvenience with menstruation, pregnancies & birth, so let guys wear a condom and get a vasectomy when it's time. That's my advice to young women.
11
Ms Agha: it sounds like your depression existed prior to any need for contraception....something way off in your hormones plus some underlying mental history.
I also wonder why nobody thought to try an IUD, since you can get them without hormones (and yet, they would lighten your periods).
Ultimately, if you cannot tolerate ANY contraception and cannot tolerate ANY menstrual cycle....there is only one answer: a total hysterectomy. (Sterilization would not do it, Allison from DC, because she'd keep menstruating.)
It would be very sad to be sterilized so young and what if you want children someday? But it would be better than living in constant misery.
3
Adoption would have been perfect for me as I was an unwanted kid that needed REAL parents. The pain and disability that hit me 14-20 days every month was unnecessary. Knowing what I know now, I would have had a full hysterectomy at 15. There are things far worse than sterilization. Matter of fact, it was the very sterilization that you demonize that allowed me to be a real woman, a functioning human being, and a loving wife and mother. My womanhood and person is not defined by my reproductive parts.
4
Non hormonal IUDs do not lighten periods. For many women, they have the opposite effect.
3
Nonhormonal IUDs cause MORE bleeding, not less! Get your facts straight.
2
How dreadful! What did you end up doing?
I felt like hormonal contraceptives worsened my depression back when I tried them for a few months at age 18-19. When I quit them, my mood improved quite a bit.
Once menopause hit, I didn't want to take the hormones because I suspected the progesterone component would make me depressed. Depression is a lot worse than hot flashes, believe me!
Some people, men as well as women, seem more sensitive to adding or subtracting sex hormones from their systems than other people. I know of three men who took testosterone blockers for prostate cancer: one had no mood changes, the second became mildly grumpy, and the third one, suicidal. Some women feel their depression improve on hormonal contraception or menopause hormonal replacement, and others, like you and me feel worse.
One size does not fit all.
5
YES! I had this same experience on a different birth control when I was a freshman in college. The depression was not only crippling (I was suicidal to the point that I had to be hospitalized) but so insidious I had no idea that the birth control was responsible until summer came and I, who had no insurance, ran out of pills. Two weeks later after a year of not being able to get out of bed I was suddenly fine.
Years later, when I was in a long-term relationship and wanted to get back on the pill, I mentioned my fears about depression to my gynecologist and only THEN did she say, "Oh, yeah, that happens a lot, you just need to try a different method." How useful that would have been to know before I nearly dropped out of college and almost ended my life!
8
When we decided that we had enough children, I got a vasectomy. That seemed to be a much more reasonable form of birth control than having my wife taking medication which has more risk, and less certainty.
13
Why not use a diaphragm?
2
A diaphragm does not provide any protection against the severe pain of endometriosis. It simply prevents pregnancy.
3
Becoming pregnant and giving birth completely cured my endometriosis. Obviously that's not an option for everyone.
2
How lucky, really. Pregnancy made mine worse. Endometriosis is not something I would wish on anyone. I am really glad it was that simple for you. May you live a happy and pain free life. Peace.
1
Of course, it won't solve a woman's problem if she has endometriosis but I have to say, condoms are a wonderful thing.
1
What women go through so that men can have unbridled sexual access.
5
Some women appreciate sexual spontaneity without the likelihood of pregnancy, too.
3
In the late 1960's when I married there were few birth control "pills" that had research on their effects on depression. Birth control pills in the late 1960's were a terrible experience for me in both physical and mental/emotional ways. Fortunately when birth control drugs would raise one's blood pressure doctors could understand a search for alternatives. Unfortunately in 1972 as a married couple, each 23 years old, my husband and I were denied a routine vasectomy because we were "too young" to make a decision not to have children by more than one doctor! As a last resort my husband was "allowed" to have a vasectomy at the state University Medical School as a teaching lesson for students-- a significant public commitment of his support of birth control in our marriage.
My serious endometriosis was not diagnosed until my mid 30's due entirely to my not sharing with my doctors how much pain I was experiencing. Such monthly pain and difficult periods were normal for my mother and her sister. I assumed (because who discusses this with non-family members) all women experienced such pain monthly and I was simply poor at managing mine. It was not until I nearly fainted twice during meetings, that the very wise woman who was my director strongly suggested a complete review of the pain. A total hysterectomy eliminated my pain.
I join the author in urging women to be advocates for their own health and not accept pain or drug side effects without challenge. Be Strong.
6
Yes! My sister took Yaz as well and experience severe mood swings, migraines, and what I'm pretty sure was depression. It got so bad that my mother considered taking her to a neurology specialist until our OBGYN suggested in may be side effects of her birth control pills.
She's since switched to a different type of birth control pill. Her issues have since evaporated.
It's important to note that birth control pills are technically a form of medication. They can have side effects and can react badly with other medications (even become ineffective). Non-hormonal options also exist.
2
Unfortunate illustration! Just DON'T.
2
Instead of railing on and on about the pill, the author should have gotten a hysterectomy.
3
Maybe she wanted to have a child!
1
Maybe she’d like to have kids at some point?
Maybe much more research should go into treating endometriosis—but then, only women have it, so never mind.
3
Nancy R - did you skip over the part where she says she is only 24? She may wish to have children. Or perhaps not be ready for the side-effects of a hysterectomy!
2
In my late teens and early 20s, I, too, cycled through a half-dozen birth control pills, determined to find one that didn't make me a) fat (40 pounds in two months on one pill!), b) crazy (it only took me 3 months to notice I was suicidally depressive, but for no reason and only a few days a month), c) sexually inert (this time it took 6 months to realize that it wasn't my new live-in relationship that killed my libido; it was the Pill), or d) prone to clockwork vaginal infections brought on by the hormonal imbalances.
I finally did find a Pill I loved and was happily on it — thin and acne-free — for 15 years. Then I moved abroad and was told, "We don't have that Pill here, but take another one. They're all the same."
A friend stayed on a Pill for years and took Cipro the entire time to ward off the urinary infections that Pill gave her, because she was too busy with her thesis and wedding planning to experiment with other options.
Thank you for bringing attention to the disturbing reality that most practitioners regard these hormonal treatments as all being the same and having one effect — pregnancy prevention (or acne/endometriosis control). They blithely recommend the latest or cheapest pill of IUD as though they were interchangeable products off the shelf, with zero regard for the way "side effects" like depression, infections, and weight gain can literally cripple and distort women's lives.
1
This is so important, thank you for writing and publishing stories like this!
1
You didn't even mention, weight gain, loss of libido, terrible acne. I tried several variety of the pills for endo, all came with worse problems. I found Nuvaring to be acceptable and stayed on it for a few years. Now I despise all hormones and have a non hormonal IUD even though the side effects include painful periods and frequent spotting. At least my mind is my own.
I kind of assumed playing with your hormones was going to have unintentional psychological consequences. I actually knew woman where birth control was prescribed to treat a mental health condition rather than a menstrual one. The brand she took happened to be Yaz. There were probably other failures before landing on that solution. I'm not sure how many. Either way, the drug worked. She found her mind again thanks to birth control. Do women deserve more options? Sure. But let's not go overboard. A 70 to 90 percent emotional success rate for a prescription drug so broadly taken is really quite impressive. The drug is even better at preventing pregnancy so there's that too. I kind of wish they had continued with the male equivalent. I suppose condoms are just easier.
4
You are describing #pmdd and yaz can save some of our lives. ANDY
A couple thoughts:
Barrier methods can be quite effective if used consistently: condoms, the diaphragm (probably under-used).
Despite the downsides of hormonal contraception, the likelihood of death from ANY method of contraception is lower than that of pregnancy and childbirth.
2
Did you read the article? Agha took the pill for endometriosis, not for birth control. Barrier methods have no effect on endometriosis.
Well said. Women's concerns such as health issues, are beyond our control and, to some, our (men's) comprehension, better left to women to resolve; all that is left for all of us is to lend our robust support, so justice may prevail. And peace.
1
Birth control pills and other contraceptives were initially developed to prevent pregnancy. That was its original purpose, and it worked wonderfully for most women. However, hormonal contraceptives were found to have many more benefits than just preventing pregnancy. It regulated menstrual cycles, helped control endometriosis, and regulate the ups and downs of these monthly roller-coaster rides many women experience. We were pleased when these pills achieved their goal.
Men, however never go through monthly menstrual cycles and experience the daily highs and lows of being a women. Granted males go through hormonal changes but not in the course of 28 days +/- like women. Women are less likely to notice depression as a side effect as long as their pain is gone and/or their periods are regular. Men however don't fluctuate nearly as much so changes to their hormonal balance is more readily recognizable and voiced to their doctors.
I was on the pill for many years, and it performed as I had hoped. Not once did a doctor inquire about depression, because most women were pleased with the positive physical results.
I am thankful that Sindha Agha experienced those changes and was able to put it simply into words. It may help many more women and their OB-GYNs seek the right contraceptive for them, knowing depression is a possible side effect.
Thank you.
1
I had severe depression right when I started law school, which everyone attributed to stress, moving, studies - and no one EVERY asked me about medications, say, whether I had just started a new birth control pill - which I had the month school began.
Yasmin was worse. My ob put me on it after I had a baby. Within two months, I could no longer metabolize alcohol at all. A glass of wine made me nauseous. Three meant violent illness - public vomiting and appearing utterly plastered - followed by 24 hours of feeling as if I had been poisoned. Mind you, this had NEVER happened to me before. I quit the pill, and it went away.
The doctor never believed that the pill could have side effects. Yeah.
2
I have always felt that I have deserved a better treatment option for the unbearable pain and excessive bleeding that I have endured for almost every month since I have been 14(now 27). Birth control —no matter the type —always made me feel down to the point of suicidal. I vividly remember my “breaking point” on each pill where I decided that the pain was worth the sake of my mental health. I have missed school and work consistently, but sadly it is better than the “enhanced” form of depression that comes w the pill. I agree with the author that we deserve better. What has been deemed “good enough” has never made a dent in how I feel to the point where I feel we have a made a real medical breakthrough.
1
Thank you so much Sindha Agha. You told my story (and apparently that of so many other women). For me, my undiagnosed (for many, many years) thyroid problem caused my endocrine system to go haywire--including major problems with my hormones and periods. I took birth control pills to take care of those problems and they caused me to lose my mind, be misdiagnosed with psychiatric illness, and, in general, made my life a living disaster. In short, medical malpractice (that's what it was, no skirting the issue) destroyed my life until I got wise and started taking control of MY health. I'm in charge now--not ignorant medical professionals who didn't have my best interests at heart.
For all those naysayers (including doctors--and even female doctors who should know better), walk a mile in my shoes before you judge me. I have a right to stand up and say "enough" to life-destroying side-effects. As a mature woman, I will no longer tolerate this kind of treatment. As a patient, I have the right not to suffer from life-altering side-effects, just because the treatment *may* have produced "good" results, otherwise.
It's not one size fits all and the sooner society and the medical profession realizes this, the better.
3
I understand your concern regarding denigrating contraceptives, especially in this political climate. I am 55 years old and never used hormonal birth control simply because of the too numerous side effects written in minuscule print. When looking for birth control for my two young adult daughters I did extensive research and finally, with their input and upon consultation with their pediatrician, they had the IUD ParaGard (copper) implanted. This does not solve your specific endometriosis problem; however, this will address others who are looking for an effective form of non-hormonal contraceptive.
3
This is quite one sided. What about those of us who felt tremendous on birth control? In fact I felt better than when I was not on one. The early higher dose ones were the ones that actually made me feel best.
I feel for Sindha because the side effects shuffle impacts me in other ways, is massively frustrating and seems to have become harder to manage over the years. The commenter who noted how different and hard to generalize our biochemistry can be offers a science based premise that needs to be put forth more often, particularly in doctors practices. Oh, and it is not in women's minds as a knee jerk assessment.
4
30 years ago my OB/GYN advised me against the pill because of my history of depression. After reading your piece and many of the comments, I realize he was a huge exception. Was there more awareness 30 years ago? Was he just tuned in to that possibility? And how did I get so lucky as to have a doctor who warned me about the side effect of depression?
3
Every woman is unique. I am on Yaz and if I don't take it I bleed uncontrollably for 4 days.
I tried getting off of it last year and after the fourth month I was back in the doctors office for tests and options. He put me back on yaz - said an ablation wouldn't help me I have too much estrogen. Yaz has made life so much easier for me.
I hope Ms Agha finds her solution - I sympathize with her struggle.
2
In response to Earthling's suggestion that endometriosis sufferers use opiates:
I have endometriosis. While endometriosis entails crippling pain, that is not its only problem. I've received contradictory information from the various doctors I've consulted, but a common thread is that over time severe endometriosis could cause damage to your organs (the scar tissue, for example, can cause an organ to "stick" where it shouldn't) and the continual bleeding from the endometriosis causes inflammation and pain. The goal isn't only managing pain, but limiting the progression and bleeding of the endometrial tissue. That's why doctors are prescribing hormones; pain management is not enough, and given the high risk of abuse for prescription pain killers, they aren't a good option for chronic pain sufferers. While I expect that your comment was well-intentioned, endometriosis is a confusing, insufficiently researched disorder and it's difficult to find reliable medical advice; uninformed treatment suggestions are part of the problem.
For others who may be reading these comments for advice, I quit all hormonal interventions because I couldn't tolerate them, and have found decent pain management through an anti-inflammatory diet working with a nutritionist, pelvic floor physical therapy, and acupuncture (none of which are covered by my insurance). My doctor expects that I may eventually need a second surgery because I am not using hormonal birth control to limit the endometriosis.
4
You do know it isn't as if scientists and drug manufacturers enjoy having side-effects in their products (that make them less attractive)? The fact is that biology often doesn't like being messed with, and interruptions of homeostatic patterns often result in disruptions of undesirable pathways.
The difference in standard between men and women's contraception is one of need. Men can just use a condom. The bar for side-effects is much lower due to physiology and there's nothing that can be done about it. If women had similarly "effortless" means of contraception than their bar would also be higher in terms of tolerance for side-effects.
I'm in Biotech and maybe I sound too defensive, if that's the case, I'm sorry. All I can say, though, is that people are assuredly working on it. Just like we're working on better cancer cures and a thousand other things. But it takes time. In the meantime, though, companies either offer imperfect drugs or none at all. In this case, most people pick something over nothing, especially since sales of "something" encourage research into developing "something better."
Year by year, bit by bit, we'll advance and we'll improve. It is incremental and imperfect but it is the only way to go forward.
5
Thank goodness for me, birth control had the opposite effect. I suffered from severe mood swings around my period to the point that I would have to leave my office because I was so annoyed by my coworkers that I could have killed them all. When I asked my physician, her response was Prozac. I decided to switch to taking the pill continuously so that I wouldn't have such hormonal mood swings. I am grateful that the pill fixed my problem and so are my coworkers.
1
"American public discourse doesn’t digest nuance well, and I fear not being heard if I criticize birth control and in the same breath assert my right to it." You've got that right! Good thing to be explicit: "but these beliefs are not mutually exclusive."
But I'll go further. Yes, ideally there should be birth control without side effects, but in the real world, every drug has side effects. You have to balance the pros and cons, and in the case of birth control, the pros of giving most women control over their fertility has changed the world for the better, and I'd go so far as saying railing against its side-effects is like looking a gift horse in the mouth.
Why is the name of the Pill's inventor not as much of a household name as Edison or Pasteur or Fleming or Salk or Ford or Jobs?
As for the comparison with men's contraception, the balance between the pros and cons is far less in favor of the pill than for women, but my guess is many men would rather take the pill and risk its side effects anyway, the way they risk the side effects of Viagra. The cost-benefit ratio seems to them to be worth it...
I'm female and loved being on the pill btw, it reduced the length, flow and cramps of my periods, and I want to publicly and loudly thank Dr. Gregory Goodwin Pincus!
3
I, too, had agonizing periods as a teen. Surgical removal of an ovarian cyst gave me relief at age 20. So did bearing my first child at age 22. After 3 more births 2 years apart, I was done with pregnancy and chose to have my uterus removed as a guarantee. Several years later my gynecologist suggested orthonovum would clear up my acne. Two months into this regimen, I almost died from deep vein thrombosis, spent a 6 weeks in the hospital on heparin. I advised my 4 daughters never to take hormones, but find another means of birth control. They used rhythm method and condoms, had 2 children each (by choice), then told their husbands to get vasectomies. Which they did, reluctantly, since the other option was banishment to a separate bedroom. My advice to females: stay away from hormones, have your children when you are in your 20s, then only have sex relations with vasectomized males.
2
I am sympathetic to the author's situation. Birth control is one of the most amazing, and frustrating, developments in our modern world. It can literally save your life. However, our society has such a strange view on it. Some treat it like it's the devil as all children are miracles (not by Webster definition as there are 7+ billion "miracles" on the planet today...). Others take it for granted, like the young women who are opposed to "feminists" (just how do you think we got birth control, or the vote, or the right to own property?). Then there are the men who could easily have a vasectomy so their women don't need to deal with it, but they refuse to out of some caveman like fear (there's no evidence that it affects performance, but they still refuse).
When we get past these people, maybe then we can have a more meaningful discussion. Until then, let's not demonize the pill. It's still one of the most liberating things we've done for women since giving them the vote.
2
It is sad, but true, that humans don’t know of a cure for every ailment. The writer has never found an effective treatment for her endometriosis. Maybe, this article will bring her suggestions that relieve her pain and deal with the other issues of endometriosis. In a perfect world, an “expert” on endometriosis might become involved and provide effective treatment without such major side effects.
1
Birth control is still a wonderful thing for most people. This needs to be stated clearly, especially with the politicization of birth control as part of the abortion controversies and with a Catholic church still clinging to antiquated ideas about god's will for us to have as many babies as possible (married people could have 30 years of fertility), despite having 7.6 billion people and climate catastrophe based in part on highest historical population.
There are lots of choices for people without medical conditions, many are long term, have extremely low failure rates, and have low or no hormones involved. Seems prudent to me to use the least hormones possible and people should be aware that hormones can affect mood.
Unfortunately, some women suffer from severe pain and other terrible complications of their monthly cycles and they need all the help that modern medicine can provide, including access to qualified doctors and access to possibly expensive hormonal treatment. Anything else is inhumane, and sexist, and no religion and morality have absolutely nothing to do with making someone suffer.
Yes, please let a doctor followup this article with a well researched survey of methods, side-effects, effectiveness, etc. Unwanted pregnancies are also very hard on a woman's body ... and their life and our society and again world population growth , we just don't need extra people who may not have family resources and engaged parents to help them grow beyond the womb.
2
Truth telling and a powerful video, a teaching moment for anyone with illness on the value of documentation.
"My disease doesn't define me" talk is inhibiting. Get into it, as your health is your life's work as everything flows from waking up in the morning.
2
Thank you, Sindha Agha, for sharing your experiences with us, I can only hope that they might help enlighten the broader community regarding the difficulties facing many women when it comes to the reproductive health of women. Several years ago a woman I was on a date with told me about her struggles with endometriosis, which had unfortunately ended in the complete removal of her uterus. It seemed (to me) a radical thing at the time, but considering the fact that she was able to live a pain-free life, without having to deal with any side effects from birth control, perhaps it wasn't such a radical idea. Men often seem quite excited when they hear a woman they're dating is "on the pill" (causing them to assume certain facts not in evidence), but those same men rarely take into consideration what "the pill" might be doing, aside from preventing unwanted pregnancies. Sure, they might be preventing painful periods (and other associated things), but the other side effects? As the joke goes, if men could get pregnant, birth control would be available on every street corner--for free. Well, in that light, shouldn't we take some care and develop some birth control that doesn't have such nasty side effects?
Oh, wait ... I believe it's called the condom.
We should stop calling it birth control. There are so many reasons people take hormonal medications. It is a huge disservice to continue to call it such for all the people taking it for non contraceptive reasons, such as endometriosis. Consider that "birth control" is merely a side effect for so many.
5
This is so sad and yes, depressing. On the other side of menopause, life is good, but that's a long time to wait. My younger daughter got a pulmonary embolism from Nuva Ring, but luckily, did not die from it. You are right, we need better birth control!
I hope you soon find relief.
2
I truly believe that if men could get pregnant, there would be far better birth control methods with few side effects and ... abortion wouldn't even be an issue. Just legal in every state with no discussions of trying to put limitations on them or having a "waiting period" from seeing a doctor for the first timed!
2
You're not alone. I went on birth control for the more common reasons; I went to college and got a boyfriend. Over the course of the next 6 months I felt all happiness in me slip away, my anxiety levels skyrocketed, and my libido was non-existent. By my senior year I was having panic attacks, and I was prescribed Paxil, which only made me violently sick to my stomach. My moods were erratic, panic could grip me at any time, and never did I connect it to the pills I'd been taking every day for the last three years. Eventually my boyfriend and I broke up, so I stopped taking the pill. My mood rapidly improved, the panic subsided, and my libido came roaring back. Still I didn't connect it all to the pill, and neither did my doctors, although after the Paxil debacle I never talked to them about my mood again.
Fast forward a few years and I'm dating again. As things started to get serious, I decided to go back on the pill. The next thing you know my moods are erratic, and I have no interest in sex at all. Panic begins to creep on me again. It was only after I tried 4 different versions of hormonal birth control that I put two and two together. We switched to condoms, and everything was good again.
The panic and erratic moods did return one more time, in the months after the birth of my first daughter. There's something about the hormones that messes with my mind. Thankfully I never took the pill for any medical reasons. Condoms do the trick and I get to feel like me.
1
Amen to this and to your clear articulation of a bind so many women face. We need access to birth control that recognizes hormones have a big impact on multiple aspects of life. However, as a Chinese Medicine and Arvigo therapy practitioner, I also advocate for alternative treatments that begin to address the underlying causes of menstrual irregularities so that the menstrual cycle is a easy normal part of a woman's experience. (Yes, that is possible.)
I know from my own experience treating my hormonal cycle issues ("Oh God, should I jump from this bridge" --when the PMS was really bad) and treating many women as a practitioner, that alternative treatments are often effective with little to no side effects. And fundamentally they address the issues that have caused the endometriosis, PMS, PCOS, etc. Treating hormonally produced disorders with more hormones is not the answer.
If we can address women's health with more tools than just BC pills then the pill will be available for its main purpose. Girls and women deserve health care that focuses on their whole health, and is not in thrall to the pharmaceutical industry!
1
There was an article in the NY Times recently about birth control pills and developing cancer. It is a small risk but why take the chance. You are putting hormones into your body which cannot be healthy over an extended period of time.
2
I am appalled and saddened to read these comments about the pain, depression and suffering so many women have experienced through using some version of hormonal birth control.
Did their health care professionals never recommend they try barrier methods--the diaphragm and the condom ( sic!) which, IF used properly worked well for so many of my older generation and did not have the side effects.
Currently the highly recommended methods are LARC's (Long Acting Reversible Contraceptives--IUD and injections) which have been found to be highly effects and easy to use, and so far not been found to have side effects.
Most important we need a lot more talk about ( and research on) MALE contraceptives. Only a couple of comments here mentioned that men should bear equal responsibility for reproduction-- and the health care community should insist on this too. Let's all recommend that the new ME2 movement add this to their evolving agenda?
3
Many commenters have pointed out that the writer has a pain problem not a birth control problem. I hate the tone of this article. Pain management and birth control issues are not caused by sexism. Heath is tricky for all humans — male and female. Most doctors are doing their best. Science has given us many solutions but it’s not magic. No we don’t have perfect birth (or pain) control products, but we also don’t have a cures for cancer or even the common cold! It’s not sexism.
5
When using birth control for the purpose of actual "birth control" my first wife discovered she could not take hormonal pills of any kind without making her feel really weird. Her gynecologist suggested we try contraceptive foam. It worked like a dream with no side effects, and it was VERY effective at preventing pregnancy for 7 years.
The minute we decided to "get pregnant" she stopped using the foam, and during her next cycle she got pregnant. One caution----- you need to be sure to use it EVERY time. After we had as many kids as we wanted I got a vasectomy. I highly recommend that method of birth control.
4
I have been prescribed a hormone for a painful skin condition. It is a common hormone but priced very very high at the pharmacy. I was told it is not covered by my insurance. They said they do not cover female hormone treatment. I asked my doctor why it is not covered and she said it was sexism. Plus the fact that insurance companies don't want to pay out if they can avoid it. My doctor told me to buy the drug from Canada, it is one fourth the cost there.
6
Thank you for telling your story. I've also suffered from depression due to birth control. I believe the actions and stories of brave women like you will have a great influence in establishing gender equality in terms of contraception. It's about time.
2
Thank you for describing the possible health risks associated with taking birth control pills as well as the benefits. When they became popular in the 70s the strength of the pill (the few variations available) were not questioned. And women were not supported for raising concerns. Today, surely the science and options could improve options beyond where we are now. On a less related note, I would like to see birth control pills prescribed with more care and follow-up and be offered for free along with vasectomies and tubal ligations.
6
Unfortunately, there are many common drugs that exacerbate depression and anxiety. The medical profession doesn't seem to know about this, or care, unless the patient brings it up.
7
Thank you so much for this essay! I had this experience recently -- my doctor prescribed hormonal birth control to lessen the effects of a fibroid and "reduce" menstrual bleeding. After just one week I wanted to hurl myself out a window -- repeatedly. I wish more people were talking about the effects of hormonal birth control and our sensitivity to estrogen, progesterone, progestin. I really really really appreciate everything you've written here -- and I too hope we can come up with better options.
9
Yes to all of this. I too have repeatedly been prescribed semi-continuous birth control to "treat" endometriosis and a fibroid. Previous attempts to take birth control have left me feeling depressed, anxious, not myself. I have yet to meet a doctor who really understands this. I have never understood treating a disease that is the result of (and results in) high levels of estrogen, with more estrogen.
1
I was prescribed birth control pills when a student in college in the '70s for polycystic ovarian disorder which caused irregular periods, heavy bleeding, and unbearable cramps and nausea. I took the pill for 6 months. I gained 30 pounds and had a brief break from the menstrual pain that I had endured through high school. The withdrawal from using the pill was worse: among other symptoms, I experienced an anxiety disorder that prevented me from sleeping, and, of course, the cripplingly painful menstruation returned. Trials of different birth control formulations did not achieve any better results. Ultimately, I chose to have both ovaries removed when a stealthy cyst managed to grow to the size of a grapefruit. Fortunately I was already menopausal by that time.
I was surprised to learn at my ob/gyn's office recently that no one there prescribes a diaphragm anymore. I wonder how many of our nation's young women are hormonally altered, in an effort to be "liberated" women. It's high time that a dialogue between partners becomes common when hormonal contraception is this risky.
7
I also have taken birth control for endometriosis for many years. I'm lucky that I haven't had the side effects that Agha describes. However, I was alarmed to read quite recently that taking birth control pills (even the modern "low" doses) significantly increases breast cancer risk (https://www.nytimes.com/2017/12/06/health/birth-control-breast-cancer-ho.... Agha is right that we need better options.
11
On the other hand, in an article published in the Times December 11, 2017, David J. Hunter, a professor of epidemiology and medicine at University of Oxford in Britain cited studies indicating that “In aggregate, over a woman’s lifetime contraceptive use might prevent more cancers” than it causes. See:
https://www.nytimes.com/2017/12/11/well/live/birth-control-pills-protect...
2
Thanks for that article. It is complicated! The effect on an individual woman must be partly based on her genetic predisposition to various cancers. Anyway, it's good to know that over all, the effect of birth control pills on cancer may cancel itself out.
While I am truly sympathetic to the author's plight, and open to the possibility that oral contraceptives increase the risk of depression in women, this topic would be better addressed not as a personal narrative, but as an essay written by a science-trained researcher in the field. A scientists would give us an assessment of the Danish study, along with an explanation in layman's terms, of the actual (not theoretical) increase in depression among women taking oral contraceptives.
Unfortunately, many people trust personal narratives over essays addressing what science knows or doesn't know about a given topic. This is exactly why we have so many anti-vaxxers out there, and it's one of the major reasons our ability to understand science is steadily eroding.
59
I don't know. I think that this piece as an essay helps relate the information better. It's more interesting to read and still accomplishes the main points. I understand that birth control can cause depression for some people, and that it's backed up by a study. I don't need to know how the study was conducted, or the actual increase in depression among women taking oral contraceptives but if I did I can find that information in the linked study/story. Instead, this humanizes the problem that's already been explored by science while talking about holes in the treatment of endometriosis.
3
I had the same thoughts and I went back and looked at the Danish study. One point is that approximately 98 % of women using hormonal contraceptives did not develop depression. Another point is "detection bias." Women who are prescribed contraceptives go to their doctors' office, get screened for depressive symptoms and are subsequently prescribed medications for this condition. Women who use condoms or are abstinent may be depressed but may not be diagnosed if they are seen less often for reproductive health visits. Dr Jen Gunter has recently signed on to the Times as columnist, this would be a good topic for her. She did talk about it in 2013 - https://drjengunter.wordpress.com/2013/08/10/does-depo-provera-cause-dep...
19
We need more personal narratives. Scientific papers assessing studies done overseas generally won't find their way into the reading material of the average woman who needs or believes she needs contraceptives. Birth control pills raise the risk of stroke. Childbirth comes with a much higher stroke risk. Many women experience cyclical mood swings which can stem from hormonal shifts which cause digestive discomfort which could be remedied by an increase in exercise which often cannot be achieved because the girl or woman is sitting at a desk at work or in school for nine hours. And, women still are discouraged from talking about below the waist physical discomfort.
10
I was.diagnosed with endometriosis, fibroids, and polycystic ovaries at the age of 16. I was also diagnosed with migraines. Doctors were certain birth control would fix everything. While I do not remember being depressed or even being moody, I did continue to have headaches and pain that would keep me in bed 7-10 days out of the month. 'Stay with the program, it can take a few months for your body to right itself' was what the doctors said. I stayed with it until I was 21 and married. Then I got pregnant, yes on these pills. The doctor was thrilled.because pregnancy would fix everything. It didn't, Fast forward 10 yrs of more of the same old stuff, an ovary and appendix ruptured. Doctors suggested I have a total hysterectomy. I have had no mood problems, 4 migraines in 20 years and no pain. My problems.were mostly estrogen based. I should have been offered this at 15 as I did not want kids.
Not being able.to give birth is not the end of the world. Adoption make you a REAL parent and you can live a life without painful periods. Best wishes on finding good health.
21
There is NO WAY you would have found a doctor willing to do a hysterectomy on an otherwise healthy 15 year old!
This is something that is very sexist: doctors not letting us have hysterectomies because we may change our mind and want children. They do not seem to trust that we know what we want. So instead we suffer. For decades.
For myself it means I take loads of medicine to keep my body from killing me so I can have a hysterectomy on someone else's schedule (which even at 47 my doctor - and the 2nd opinion doctors - say is at least 15 years away.
2
For context, endometriosis is a menstrual disorder in which tissue similar to that of endometrial tissue (what gets shed during one's period) grows outside of the uterus. It still responds the same way to changes in hormones throughout menstruation so it bleeds and causes lesions and scar tissue on other organs each cycle. And since it can't escape the body, symptoms tend to get worse over time. No one knows exactly why endometriosis occurs, but birth control, more often than not, gives the most relief for sufferers. Like Sindha Agha, I also have endometriosis. But unlike her, I found that birth control actually helped my mood even out and helped my pain from endometriosis at first. Also unlike her, overtime my endometriosis began to cause daily pain that even my recent surgery, my birth control, and 4x the normal dose at 1.5x the recommended rate of ibuprofen can't lessen. Hers seems to be along the lines of having no pain while on birth control or having painful periods while off birth control. But in the end this isn't a pain game. This is a call to say that, as Sindha Agha put it, we deserve better birth control. Everyone experiences menstruation differently much like everyone experiences endometriosis differently. There is no "one size fits all" for menstruation so why should this or that birth control be considered a "one size fits all" treatment?
81
Not only do we need better birth control, but 'we' (I'm male, but I sympathize) need better treatments for endometriosis and all other types of dysmenorrhea. My daughter suffers such pain that she is barely able to function for a couple days most months with cramps so bad that she will throw up ibuprofen.
3
If men menstruated and developed endometrial issues - I truly believe there would have been effective remedies developed - centuries ago.
3
Sounds to me like there should be a better treatment for endometriosis.
4
I can definitely relate, and it was certainly disheartening to find out the glaring double standard in medicine based on gender when it came to the male birth control study. OB/GYN doctors need to be more transparent when prescribing birth control medication and there needs to be more cross-pollination of information between different doctors like psychiatrists to properly diagnose a condition. I also have struggled with anxiety and depression and never knew that birth control might've been the culprit. Thank-you to the author for illuminating this important issue that's often overlooked and how women are disenfranchised by the medical community.
4
Try reading the package inserts. Not just once, but, at minimum, once a year (changes are made when needed, when new side effects come to light, so if you think you may be hormone sensitive read them more often). Don’t count on any doctor knowing it all. They don’t, they can’t. Whether male or female. Now, you can keep up researching on the internet (no such luck 46 years ago). I had a friend who had endometriosis. Doctor wanted her on the pill, but, her church said no. She was well under 14. Suffered & had a passel of kids, had 3 husbands, died young. I tried the pill when first married, made me suicidal, quit, used condoms, had no kids, 1 husband, still alive. I live, sober, with chronic pain, which does make each year seem longer than I think it should. But would I switch places with my friend? Nope. If I had been her I would have fought for a hysterectomy. I couldn’t have raised healthy kids while living with that pain. It’s one reason we never had kids. No one should be obligated to reproduce. In fact in todays world you should have a very good reason to even think of reproducing. Having someone to take care of you in your old age isn’t it. Neither is keeping the family name going. Mine will die with me. So be it. No one is that important. Not even a genius.
Thank you so very much for telling your story. I have a similar story...ten years on contraceptives and ten years of terrible, debilitating depression and anxiety, without knowing the cause. Not once did any of my physicians connect the two. Once off the drug, I improved dramatically. Only years later, when on hormone replacement therapy, did I realize the connection between my prior depression and progesterone. I dropped the progesterone and did very well on the estrogen alone. Thank you again for sharing your story, as I thought this situation was specific to only me.
6
Interesting. I'm in my mid 40s and have tried a few birth control pills over the course of my life, for birth control as well as for PMDD. All of them made me feel terrible, with extreme mood swings and constant nausea. Even low doses were not tolerable. I was never able to stay on anything for more than a few months and eventually I gave up. That said I've never known anyone else to have problems with hormonal birth control and figured I was an anomaly.
10
The same thing a happened to me (I quit forever after a year of "experimenting" with different pills) and a grad student of mine who was about to quit the PhD program. In her case a FEMALE psychiatrist had instantly prescribed an anti-depressant (although she had no prior history of depression), but never asked whether she had recently started hormonal birth control (I asked her - and she had). I advised her to get off the pill before she started the anti-depressant, and see if she would feel better. She reverted to her usual stable, smart, and non-depressed self and is currently finishing her PhD. I agree that we should not toss out the baby with the bathwater and that hormonal contraceptives are incredibly important for women's self-determination, but that drs are still not making the connection (especially female ones who may have personal experience) is scandalous. We should at least be told, to be able to make informed decisions. And by the way, a diaphragm and condoms as an alternative have a high safety rate and certainly worked for me.
13
This is a real issue affecting many people. I'm glad to see it being discussed here - raising awareness is the first step toward a solution.
5
This article has resonance with the Hormone Replacement Therapy that was given to women for 30 years before clinical trials were finally done and revealed significant cardiovascular and cancer risk before the trials were even completed. The untested assumption that "replacing" the hormones that decline with menopause would undoubtedly improve health and keep women "youthful." Hormones are part of a regulatory system in the body interconnected with a complex physiology that is often unappreciated. Individual variation significantly affects how any one person will experience the effects.
It is important for young women opting for oral contraceptives to be aware of the risks so they can make informed choices and recognize symptoms that may indicate a significant adverse effect. While many women may never experience these effects, the assumption is again being made that given the amount of time oral contraceptive medications have been used the risks are negligible. This is clearly incomplete information and not applicable to everyone. Interesting too that the attention to "safety" is gender biased and begs the question why so long for a male contraceptive pill?
Thanks for this brave and informative article.
7
Thank you for your honest words. Many of us can relate to your plight. It is time for a safer alternative to be found. If men were in this position, -the pain, the depression, the mood swings, the alternatives would have been found long, long ago.
13
I've had a similar experience with long term depression and birth control. The frustration and disappointment never seem to end, as there never seems to be a combination that works and yet allows me to stay me. I suspect that this is another one of many experiences unique to women that we keep to ourselves, and therefore never know how we are surrounded by others with whom we can share our story. And the mind-boggling double-standard of the pharmaceutical industry vis men, birth control, and depression is just another example of 'things that will maybe be changed by the #metoo movement someday'. As my mother has always said, if men could get pregnant, abortion would be a sacrament.
10
Sindha, Thank you. One area where "modern medicine" seems rather backwards is in documenting and communicating this level of detail, and as a male I can't help but feel guilty that my sex set the ground rules that have given the world dozens of formulations of birth control pill for women, and nothing along those lines for men. To be fair, by the time the researchers and industry got serious about a pill for males--which by all accounts was a much tougher problem to solve, the rules had changed for new drugs.
I'm no expert and it won't help you now, but I think we should hold out some hope that disorders like endometriosis may benefit sooner rather than later from gene therapy and personally customized medications. Trying to treat the wide spectrum of endometriosis symptoms with a medicine developed for birth control probably works reasonably well for many girls and women, but, clearly, it does not work at all well for all of them. Hopefully there a good organization or community to work with. Keep being an advocate.
11
Thank you for addressing these subjects. Too often, anything having to do with "women's problems" is taboo enough that non-sufferers don't understand and sufferers are shamed into silence. Failure to discuss these topics in the light of day reduces hope for progress, while awareness and overcoming secrecy can allow for progress and hope for better for girls and women in the future.
14
THE ENORMOUS Unrecognized suffering and struggles of the writer are a wakeup call to those who are unaware of the complexities that women face during their lives that men do not. Words fail to convey my sense of sadness and reparative wishes for the writer. I don't know what else she can investigate. But I wish her well, with the hope that she can live, if not contented, then at least passably comfortable.
22
I am 56. When I was 11 I told a (male) doctor about my extremely painful periods. He told me the pain would go away when I had a baby. Nope, I had my daughter when I was 34 and continued to have painful periods. Finally got diagnosed with endometriosis at 48. Thankfully, I went through menopause at 50 and am delighted to have that behind me. As with so many things, if men could get pregnant, suffered monthly pain and side effects of birth control, we wouldn't even be fighting for reproductive rights. Thank you for sharing your story. I will pass it along to my own daughter who I have taught to be a great self advocate for her own health.
64
Has no physician informed you that your chronic pain syndrome is one of the few chronic pain syndromes that is in fact fairly easily solvable?! Ask for a hysterectomy - preferably laparoscopic. You'll likely not even need to spend an overnight in the hospital, and will feel as good as new with a week or two of recuperation! Best wishes.
12
Sindha Agha is only 24. Perhaps she would like the option of giving birth to a child someday? Also, some women continue to experience endometriosis pain after hysterectomy (for example, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286861/).
Hysterectomy only works if the disease is confined to the uterus and pelvic organs. In a lot of cases, endometriosis spreads beyond those organs, to the bladder, rectum, bowel, sometimes the inner skin of the abdomen and can go as far as the lungs. The most effective treatment today is excision surgery, which is basically radical removal of all lesions by a method which removes the root of the endometriosis implants. There are a handful of surgeons who do this type of surgery in some states, the vast majority of OBGYNs are clueless and only burn off the lesions, causing them to grow back, or suggest..drum roll... hysterectomy, which doesn't work if there are implants elsewhere, and there usually are. Some surgeons take insurance, some don't. In a lot of cases, there are out of pocket costs, so access for all women is not a sure thing. This is a very dangerous comment. Please do not make comments like this unless you are fully informed on a disease.
2
Your comment is spot on. VERY FEW doctors understand how to surgically treat endometriosis. One fantastic doctor who does is Dr. Rakesh Mangal in Houston, Texas. I was very lucky to find him for treatment. He explained that the reason so few doctor understand endometriosis is that it falls between the cracks of practice areas. While the only real treatment is surgery (birth control manages symptoms but does not treat the condition), surgeons’ impulse is to cut out a woman’s entire reproductive system rather than remove the endo growths and leave the woman intact. Gynecologists do not generally have well-honed surgical skills. OBs are in the middle, with some taking cases of endo, but the majority focusing only on pregnancy and delivery related procedures. The result is that the condition is not well managed/treated/recognized/understood by any of these doctors, and very little is taught about endometriosis in medical school. Thus, to become an expert in the condition, a doctor has to take it upon himself. But there is little incentive to do so, because the condition receives virtually no research attention or funds. This is why there has been no advancement in treatment in decades. It is a sad and frustrating situation. Hopefully a change will come soon.
My wife suffered greatly from endometriosis. Three operations and hormone therapy did not work. What worked was fasting and dietary changes. Unfortunately, twenty years later she now suffers side effects from the operations with scar tissue causing serious problems in her abdomen.
16
This writer's experience shows that everybody literally has a mind and body of his or her own. That is, one can never exactly predict the effect of a medicine on an individual person; there are only patterns that emerge when thousands of individuals are treated. No doubt this is what her doctors meant when they said, "see how you feel."
Life is that way - patterns are easier to see in retrospect. But sometimes we humans see patterns where they don't exist. I wonder whether her doctors were as flip or uncaring as they are depicted.
I hope that this piece will inspire lots and lots of people to go into pharmaceutical research, clinical trials for new medicines or patient care.
Nobody should go into medicine, research, writing or film-making without ensuring that everybody always gets what they "deserve."
P.S., if someone would just define what it is that people "deserve," it will make everyone's jobs a lot easier. In the meantime, my compassion goes out to those whose work involves compassion.
8
I had a Mirena placed because it contained the progesterone needed to balance out the estrogen I was taking for menopausal symptoms. Within a day I was weeping uncontrollably at a documentary about a peach farmer. It wasn't that sad. Two days later I had the Mirena removed and stopped the estrogen as well. I'll take hot flashes over despondency any day
25
1) I truly hope you find the golden combination to be the best whole self you can manage.
2) I loved this article. I LOVED the little film! Excellent, excellent!
3) More please.
14
Watching this, and reading the many comments citing similar stories almost brought tears to my eyes. I have long been suspicious that my birth control pills, though sparing me missed school assignments and unbearable cramps, were wrecking some intangible havoc on my psyche. I have struggled with anxiety and depression (not to mention weight gain and acne) for as long as I have been on the pill. Though some of these are just factors of young adulthood, I know that my birth control holds some responsibility, I feel it in every withdrawal headache I have during my placebo week at the end of the month. Thank you for articulating this so clearly.
24
I'm so sorry. Another misconception is telling women they should take a placebo week of pills so they can menstruate. It is totally unnecessary. I have endometriosis and experienced brutal withdrawal migraines while taking placebo pills, so my doctor advised skipping the placebo pill week which helped tremendously. Of course, insurance will only pay for your pills every 30 days, so you will have to pay out of pocket to get a new pill pack every 3 weeks. Yet another insult to injury and indignity thanks to insurance companies who assume one size fits all for women.
1
Thank you for this. I took Lo Loestrin for several years to help with very heavy periods from fibroids (not, as another comment asserts, because I didn't "want to bring a life into this world-" where's your research on that, by the way?). Like the author, I never equated the birth control with the sadness I experienced, nor did my gynecologists ever discuss side effects. I have started being more assertive when speaking with my doctors, asking more questions, and doing more research on our own. Yet, the doctors should be more informed; when is the last time the curriculum and residency experiences for a gynecologist have been examined. While I hope there are now more women serving in this field, historically it's been (white) men examining and making decisions about women's bodies and how to treat them. This needs to change.
17
What makes you think a woman gynecologist who has never had pain or depression accompanying periods is going to be better than a man who has, obviously, never had them. A doctor who is well trained and listens to the patients and stays on top of the latest studies and literature is what you are looking for. My husband, an OB Gyn, has put it well. He says he is in awe of what women do and what they have to put up with and takes their healthcare very seriously. Conversely, some women doctors have never had it happen to them so they say snap out of it. There are all kinds of people out there practicing medicine. Find one who is learned, compassionate and who listens to you. And make sure they are Board Certified.
8
I started on the pill in May of ‘71, married in September, was in an emergency clinic at a Naval Hospital in October. Found out that in some women any birth control pill can cause depression so severe it causes suicide. Like me. I just attempted it poorly. Been married 46 years. From then on we used condoms, carefully. I’ve dealt with chronic pain for most of those years, from other causes. I was on an antidepressant for most of that time. When I first went on it, I read all the package inserts, so I knew the risks. I lived with, what’s it called now? IBS? Was Spastic Bowel when it started, every 10 years or so it’s name was changed slightly. I’d weaned off most of the anti depressant, just a few years ago. For some reason I read the insert I hadn’t read since day 1. It could cause IBS. I stopped the antidepressant, within a year my IBS was gone. I still carry an adult diaper with me, just in case, & wear one if I’m going someplace I don’t know where the restrooms are. Had a family emergency last fall, bad enough to put me in a major panic attack that lasted weeks. Then just tapered to the anxiety I’d felt all my life. My doctor asked me if I wanted to go back on an antidepressant or an anti anxiety pill. I’d rather die than take an antidepressant. So, I picked the other. I now know what it feels like to not be anxious or have panic attacks. With every refill I read the inserts. They do find new side effects, put them in the inserts, but if we don’t read them, we won’t know.
I got my first prescription for birth control pills at a women's clinic on Haight Street in the 90s. A short time later after taking some of the pills according to the daily dosage I kept thinking about flinging myself off a landing of the stairs that went down to the shared backyard of my apartment on Delmar St nearby. I had never had such random self-destructive thoughts before. I stopped taking those pills and tried another kind, but stopped taking those too for the same mood-altering reason. Since then, I just considered myself not a candidate for birth control pills and never tried any others. Sadly it did affect my sex life to a degree, but I just wouldn't use hormonal pill therapy. I don't hear people talk about this subject much, if at all, so I had to chime in with my experience. I did not have the unfortunate condition of endometriosis that this author endures, and I wish her and others like her well.
22
Thank you for this article, and short film on this subject. The side effects of hormonal birth control and the quest for better options should be more of a national dialogue than it currently is. People are often afraid to bring up the negative side effects because hormonal contraceptives overall, have been so important to women's control over their lives and because reproductive rights and contraceptive choice are frequently under political attack, but the reality for most women is complicated and many feel conflicted. We need to talk about it openly, frequently, and be honest about the downside.
23
So true. I thought I was the only one who couldn't tolerate hormonal BC pills, until I started bringing up the issue with other women. I found so many who also had problems. OB-GYNs are not honest or direct about this at all.
1
There are to my knowledge no effective medications that do not carry the risk of serious side effects for some patients. Those registered in pre-introductory clinical trials are listed on the package circulars that accompany original packages and again to the best of my knowledge are listed in the printed and online literature available to anyone who seeks them. Having worked in the industry for 30 years I am aware of no secret conspiracy between pharmaceutical companies, the FDA and NIH to conceal such information from consumer victims. We could, of course, always benefit from NIH studies that kept more extensive data on reported side effects after release and wider use. That requires Congressional funding.
In any case caveat emptor. If it works it most likely carries a risk of side effects that may preclude use and make alternate therapy advisable. Perhaps, as suggested, hysterectomy was indicated in a case of endometriosis that proved untreatable by hormone therapy. The pity is that such alternate treatment would be denied if available and desirable. One commenter to this article mentioned such denial. Could the reason have been some religious taboo on the part of the physician who tried to prevent it? One must always be cautious of that. Again caveat emptor. Be careful of who is chosen and trusted for gynecological care!
25
Think you miss her point - that better birth control is indicated.
Yes, caveat emptor, but "buying" medical services (should) come with a different level of trust than one has when making commercial decisions. Medical providers, while not universally infallible, take oaths to serve the interest of their "customers," most other "venditors"
Physicians do not have religious taboos against hysterectomies. You are projecting.
1
Birth control can be hard on undiagnosed thyroid disease. Estrogen is a partial antagonist to thyroid hormone, which means birth control pills can worsen hypothyroidism (which is correlated to depression, low energy, mind fog, anxiety etc.) Low thyroid hormone tends to cause heavier periods.
Conversely, hyperthyroidism can make a person hypersensitive to progesterone. Periods may be lighter and scantier, but are not necessarily pain-free. Heart rate increases and a severe bout can be mistaken for anxiety or even mania.
I would recommend a second ob-gyn opinion for the pelvic pain (laproscopy may be needed to confirm or disprove endometrosis for real) and/or ask to be referred to an competent endocrinologist who has an understanding of thyroid disease and female hormonal issues.
Birth control is a valuable aid for many women struggling with painful periods and endometrosis, but it is an aid only, not a cure.
22
This is the first clear explanation I have been able to find on the interactions between estrogen, progesterone and thyroid hormone. It explains, in part, why fertility treatments had such a negative impact on my thyroid health.
3
While I very much appreciate the article and its focus, I find the illustration of spotted panties is in poor taste.
7
I also looked at that graphic and said "yuck"! Who thought of that bright idea? If I were their boss, they would be gone in a flash. Sorry, but that's just plain gross (and I'm female).
1
That opening graphic is creepy.
5
I wonder if the author was ever told about the treatments that Dr Hilgers does in Omaha, NE to help alleviate endometriosis. DrHilgers.com
My wife has endo, Depot Lupron ruined her life. It’s so hard being a woman, it’s never easy.
4
Endometriosis sounds really awful. The best solution would be a hysterectomy. You could always adopt a kid if you wanted one.
6
I don't quite understand the aggrieved tone of this article. Nearly all medical treatments may cause side effects and some can be awful - talk to anyone who has had chemo or radiation for cancer. It is certainly unfortunate that she has not found a better treatment for her endometriosis but that is not the fault of society or even the pharmaceutical industry. Hormonal therapy works well for millions of women, and birth control prevents unwanted pregnancy. The fact that they are not 100% free of side effects for all people is a function of biology, not society.
11
I've never been on hormonal birth control, and yet I experienced suicidal depression for almost a week before each period. Luckily, it remitted once I got my period, but then I had to contend with terrible cramps and swelling. Later in life, I got a DVT--a blood clot in my leg--so I'm glad I never took the pill. We need new methods of birth control, for both women and men.
3
but deserve AND can it be going to happen, Can they figure out how the chemicals of female cycle plus the added chemical create the depression. That research is a question of funding Will Bill Gates fund it. Right now Congress will not. .
I had the same kind of intense pain from junior high into my 20's. It was unbelievable pain and sweating with nausea sometimes that sent me reeling home from school and later offices in work-life. It was very embarrassing to have this happen every month! My mother never had any answers for that pain. I used music to get my mind focused on the sound. It helped get my mind off the pain somewhat, - at least it got me through the 8 hours or so of the unbeleivable pain. I got the first relief by way of the pill Ortho Novem in my 20's, until my doctor took me off the pill due to cervical cells that emerged and needed office surgery, "freeze burning". After I gave birth to my daughter, I never had menstrual cramps again. The pill did not effect me emotionally, but the endometriosis did! I just read where one girl got relief by prescription Motrin. We didn't have Motrin when I grew up but looking back, I can't believe my mother never offered aspirin at least, to get the blood thinning and moving. I would try aspirin or Motrin today. Anyone with endometriosis has the right to see a gynecologist to find a solution to that monthly one-day of crazy menstrual pain.
1
Took BC pills in the 60's, they were very high dosage estrogen back then. I cried all the time, gained a million pounds and my hand went numb. When I stopped taking them and the cloud lifted I quickly decided that our behavior as human beings is never a true decision process, but the decision of whatever chemical balance we have in our bodies.
1
Thank you for finally making public with what I and countless other women deal with every month. PMDD/PMS and endometriosis are terrible aspects of many menstruators' experiences. Until the internet, I had no way of knowing I wasn't a freak. Doctors did not help until I could better articulate what I'd learned from online resources created by women like us.
3
Fifty years ago endometriosis was rarely diagnosed. I was among the women treated with a dozen different hormones in increasing doses in the hope that something, anything would work. Some treatments made the endometriosis so much worse that I needed major surgery.
I bled through everything, had a year of "false pregnancy" complete with morning sickness. In a deep depression I decided to abandon treatment, and like the author I finally felt healthy for the first time in a dozen years. The thought that treatment is still in the try-this-and-see-if-it-works stage fifty years later makes me angry and sad. If men experienced deep pain and crippling depression it wouldn't take fifty years to find a solution. Women deserve better.
12
This video is so one sided and offensive to me as someone who has been a women’s health provider for 25 years. For everyone with a story like this one, there is someone whose life has been greatly improved by the use of hormone based contraceptives and the enormous non-contraceptive benefits of them. No one makes a video of how much better they feel when they are relieved of debilitating menstrual pain or menstrual migraines or disfiguring acne ( not to mention the profoundly positive effect on women’s lives when they have the ability to control pregnancy). In my opinion, negative views such as this which are widely publicized are detrimental to women’s health. So discouraging.
43
This side of the contraceptive story is widely known and recognized. However, the debilitating effects of hormonal contraceptives are real and do affect a significant number of women. It is good that this important issue is given wide attention. We need better methods of contraception than what is currently being offered.
3
The fact that oral contraceptives can cause mood changes has been known for decades. I routinely inform patients of this risk, along with others, when I prescribe them. There is no conspiracy on the part of doctors or pharmaceutical companies to hide this fact from women. Patients who are not informed of this may just have bad providers.
The author describes an ongoing struggle with depression. Why she persisted in taking various hormonal treatments in the face of this side effect is unclear. Contraception has improved exponentially in the last 2 decades, and most women tolerate them well. There are very few medications on the market which are free of side effects. Perhaps the author could use a copper containing IUD, which is hormone free.
11
May I just mention that non-hormonal IUDs are available! I don't know if they would relieve the endometrial pain but they "do the trick" in terms of contraception without messing with your hormones.
I wonder if hormone replacement therapy has a similar effect on mood.
2
When I first tried birth control, I got depressed and lost all interest in sex. The doctor thought I complaoned about the symptoms too soon, they couldn't be real. I had to wait a month to get an alternative. The second time, again, I was told it couldn't be real. It must be some guilt, some feelings, etc. I quit and immediately felt better. At that point, I had 2 kids and my husband and I didn't want more. But no, it couldn't be depression, it had to be a deep-seated desire to have 5 or 6 more kids, right?
6
Endometriosis is a disease that women are supposed to deal with quietly, without complaining, and oh, you'd better not miss work because you won't be seen as a devoted employee and will probably be passed up for that promotion.
I've suffered through it since my first period and was not diagnosed until my 20's. Because I have migraines, I could not take hormonal birth control to treat it and instead had two surgeries to remove the lesions all over my abdomen but after each, it came back in less than a year. The pain is so terrible that it stops you in your tracks and takes your breath away. After years of dealing with it, I did not think childbirth was too bad at all because at least you got breaks between contractions.
It's unfortunate that there is not better science with better treatments for women who suffer from this awful disease. It's also shameful that women have to be subjected to hormonal treatments at all - there has to be a better solution.
11
I agree that men should have a version of hormonal birth control and not just Viagra!!! Regarding medications and modern medicine: the human body is complex and modern medicine is only barely able to compete. It's good that you are speaking up about the side effects you are suffering. Hopefully, and this will take forever in this current dysfunctional political climate, Women who are interested in STEM and are allowed to have productive STEM careers will hear you and respond appropriately.
Do be glad that you've options (it takes work to go through them) and access to human beings in medicine who will do their best to try to help.
Your account mirrors mine, down to the drug prescribed: Yaz. To say I was depressed is to greatly diminish my symptoms; I was acutely suicidal for a year. Once I stopped Yaz, the symptoms improved gradually. Over 10 years later, I still occasionally am surprised that I didn't succumb to the disease in my mind.
Two other low-dose hormonal birth control pills also caused suicidal thoughts, though not quite to the degree of Yaz. The only success story is my copper IUD - no way was I willing to risk more changes to my hormones and my life.
Know that you are not alone in your story and that you deserve better. Keep searching until you find what works - for you.
6
Right on, sister! Similar, skewed logic has kept the FDA from approving an effective drug for sexual disfunction in women. We need more women running the show, from R&D to clinical testing to the approval process.
Back in the mid 1980s doctors prescribed oral birth control with about as much care as they would take in recommending daily vitamins — and probably with equal frequency. The standard hormone dosage at that time was far stronger than it is these days, and the (many) side effects were never discussed. The general view was a woman was either able to tolerate the pills (wasn’t too miserable) or she wasn’t (felt wretched). I stopped taking The Pill after suffering a particularly frightening headache, which was dismissed as a probable migraine. I found out years later that the “headache” was actually a mild stroke — caused by the hormones — the damage from which (a brain bleed) showed up in an MRI. After that I used a (messy, cumbersome) diaphragm. The only other option at the time was an IUD (absolutely, postively no!). Now, the diaphragm originated in 1882, and the concept of the IUD goes back to the days when nomads places stones in the uteri of camels in estrus. Modern medicine? Hardly.
4
Please accept my deepest sympathy. I thank you for sharing this very personal and painful information. Peace.
9
I was put on the bc pill when I was 11 and I had v painful cramps. 800 mg of motrin (perscribed) always did the job.
I was purposedly put on the pill by an endocrinologist to hinder my growth in height....today I am 5"8' compared to my 6" sister.
6
Interesting that a doctor tried propranolol on you. It caused paranoia for me.
6
I wonder if the author of this piece has received a formal (surgical) diagnosis of endometriosis. It is quite atypical for endo to be diagnosed shortly after menarche. The cyclic pain associated directly with the first few days of menses is also not very pathognomonic for endometriosis.
Perhaps the author (or her OBGYN) should have considered alternate diagnoses for this chronic cyclic pelvic pain, of which there are a good few. And with that comes alternative routes for management. Don't give up!
39
I was diagnosed at 15 based upon family history, then backed up by surgical evidence two years later. My first period was as bad as my last 15 years later at age 30.
I'm very sorry that you suffer from the pain of endometriosis. I wish there were alternatives to birth control as a solution.
Although I don't suffer from endometriosis, I can be added to the list of women who cannot tolerate the hormonal changes the pill brought about. For me, it was Dr. Jekyl/Mr. Hyde-like rage. I became afraid of myself as I cycled in/out of calm to nearly foaming at the mouth. It took me 10 years to see the pattern and change to a non-hormonal type of birth control.
I wish you could do the same and not be in pain.
5
I have a similar story. Crippled by every form of birth control, beginning at 20. Severe anxiety or depression (or both). I don't have endometriosis. I just wanted freedom from worry. I've never been able to stay on anything. Doctors thought I was crazy. I thought I was crazy. I'm not crazy. And Nuvaring? That was my last attempt, at 41. Like living inside a panic attack. Out it went. And off I went. Thank you for this. And yes, we deserve better birth control.
13
Thank you for this. Yes, it is staggering how much we ignore the effects on a woman from taking contraceptives. It is as if it isn't a side effect at all, but just a feature of womanhood.
For me, oral contraceptives created an odd paradox: put me on them and my libido disappeared, alleviating any need for contraception.
29
I've been on the Pill for 23 years, starting when I was 35. If only I'd been brave enough to try it 20 years earlier. I, too, had painful (and irregular and unpredictable) periods; I'd even pass out. I estimate I've spent about two solid months of my life enduring the equivalent of labor pains. That pain stopped like magic with the Pill. I got my life back. I took it continuously so I had no bleeding or PMS at all.
Finding the right formula took trial and error. I took a triphasic pill until I reported to my doctor that I felt suicidal (for no reason) around the second Tuesday of each month. I switched to a pill that gave me such intense migraines that banging my head against a wall brought some relief. I kept trying; I desperately wanted control over my body and pain (not to mention reliable birth control). And I got it. Low-dose progesterone pills cleared up my terrible skin and stabilized my moods. I have some anxiety and depression but they run in my family. I’ll take them over pain and pregnancy any day.
In my late 50s, I've tried to stop the Pill but I'm not in menopause yet. Off the Pill I experience PMS, mood swings, depression and IBS attacks, besides cramps. The last time I tried to stop, my hair and skin became oily, my face broke out, and I developed a taste for heavy metal. which I normally hate. I became a teenager again.
Unlike this author, I feel most "myself" on the pill; I don’t want to be a stringy-haired, pimply, cranky, 50-something brat with cramps.
14
So sorry you have had to go through all of this. As a menopausal woman it was suggested to me that I try a over the counter cream made out of "Wild Yams," because it would improve my skin and nails. I bought the cream and followed the directions which call for rubbing a small amount on either your inner thighs or lower belly. Two weeks later, I caught myself foaming at the mouth in traffic, getting upset in public and having meltdowns. I also began experiencing painful leg cramps, and breasts so tender I couldn't even look at them. When I first got online, I couldn't find any listed side effects of the "All Natural" Progestin. Looking further and searching under "Wild Yams", the main listed ingredient, I further discovered that "Wild Yams," is the synthesized ingredient for Birth Control Pills. That taking it can perhaps lead to stroke, (the leg cramps were a harbinger), and that I might well experience emotional ups and downs. It was enough to make me throw the tube in the trash, and vow that regardless of any Dr.s recommendation or that of a well meaning friend, I needed to do my homework first. A week later, I was back to my normal happy self. I'd much rather have wrinkles than lose my sanity!
7
A very good Traditional Chinese Medicine doctor cured my endometriosis. Eating no sugar helped a lot. Look for alternatives.
17
I'd be dead if I'd taken that stuff. Yep. I got abortions. A couple. But anything would have been better than birth control pills. I was the sister of a young man who died of a drug overdose and the sister of another man who straight up killed himself: yet, they wanted to give me birth control? A family history of suicide and substance abuse and ... artists? No. No. No. I knew, even then, at age 15, that birth control was a no-go. It would have sent me right to the grave. I still remember how being on the pill felt. And that was thirty years ago. Thanks for this article. Wow. A woman in the NYT talking about her body's reproductive system. A woman talking about what we go through so men don't have to go through it. You rock. You rocked my world with this article. NYT: yes! You've got this. Thanks! I don't have endometriosis but I do have mental "blessings." Anyway. Thanks!!
65
Perhaps pharmacological science, or the profit motive, doesn't move fast enough for your situation. Lamentable, even pitiable, as all unfortunate outliers can be. Serving a marketplace of tens of millions does not allow for much personal service however. Expecting such is of course adolescent in nature. Demanding such is infantile.
2
The author's problem is with hormone therapy, not with birth control. Any woman who has been through menopause can testify what hormone's can do to your emotions. Another problem is that women need to be their own medical advocates, to ask many questions of doctors and make sure they understand clearly. It is a shame to suggest that birth control pills are to be avoided across the board. If you think birth control upsets your life, just try having five kids.
7
Wow, there are so many similarities to my situation in this story, I got goosebumps. Especially about the anxiety and the nuva ring. I didn't really make that connection until now. I'm having a laproscopy in a month because I finally pushed and pushed against being put on more birth control. I don't want endometriosis, I just know something is not right and want to know what it is and how to treat it.
3
Men do not listen and until women control the reins of government stories of this sort will be written again and again and again.
6
Thank you, Sindha Agha. Thank you, New York Times for publishing this op-ed. It's well over due to see topics pertaining to women's reproductive health, and the horrible side effects of birth control. The myriad of emotions in response to whichever side effects decided to present themselves each month was exhausting. We as women don't have to "pay to play." It's not your well being for birth control. A better dialog has to come of this. Migraine headache, blood clots and mood swings aren't just par for the course. Know your body, research, talk to your healthcare provider, your girlfriends, bring it up at the dinner table . . . talk it out and sort out a good alternative for yourself.
76
If you want to "sort out a good alternative for yourself" why don't you try contraceptive foam. It worked for my first wife and me for 7 years without fail until we decided to "get pregnant" and then boom...... turns out we were very fertile, so it wasn't a fluke. One caution: Be sure to use it EVERY time!
3
As a man who had a vasectomy decades ago I'm amazed that even with all the feminist ardor on display today birth control is still seen as largely a woman's responsibility. Given that a vasectomy is virtually 100% reversible men should take at least as much responsibility for birth control as women. Lysistrata, where are you?
113
I applaud your position and wish more men would take responsibility for their reproduction. I was not on birth control to prevent birth. I was on it to "regulate" my hormones in the hope that the pill would make the fibroids, endometriosis, and ovarian cysts go away. Birth control pills are the go to treatment for "abnormal" periods.
Again, I applaud your birth control attitude. I really cannot say that enough.
Yup. yup. yup.
This says it all.
Hugs, Sindha. That's the best we have.
7
Birth control pills for endometriosis?!! WRONG - that is 40 year old out-dated nonsense.
Danocrine (danazol) specifically for endo and which reduces the endometrial lesions.
I went on it 35 years ago when it first came out. I regularly had cramps that could drop me to my knees, put me in border-line physical shock (pulse, heart rate etc) all due to severe endometriosis (Hysterectomy was not an option as I did a dangerous sport with a high risk of a 30 mph impact with the ground - nothing could have maintained the bone density I needed if a hysterectomy was done)
Danocrine worked. Stayed on it for 3 years.
The monthly cramping was lessened. I was suppose to do a 3 year hiatus and then go back on it for 3 years . Probably should have gone back on it after the 3 year hiatus but my by-then-insurance wouldn't cover it
And I learned how to mentally control the pain - to know the waves of pain, how high they went and how to ride through it and to mentally block it out.
If a period hit before I expected it, the cramps could send me leaning into a wall and going into shock. All I had to do was exercise the mental discipline, fence off the pain and block it. No pain meds, no drugs - just mental control over predictable pain
So Danocrine and learn how to mentally handle and block pain or a hysterectomy.
Birth control? Bogus treatment that didn't work 35 years ago for endo
11
I also suffered from depression when using birth control pills. I thought my life was a mess but it turned out that it was the pills.
But let me assure you, depression was not a small price to pay. I was contemplating suicide when luckily, another medical issue caused me to switch to a diaphragm.
32
I'm so sorry. My aunt had endometriosis and never got anything. I can only imagine both of your pain.
3
I can't sympathize with the author as I'm a guy. But I will make n observation that nothing is 100%. These hormonal treatments have worked for a huge number for women for decades. Just like any other medication there will always be a small group for whom it does not work. Best thing to do is accept things as they are and move onto other solutions, whether you like them or not. After all you can't undo the memory of side effects related to adverse reactions to pharmacology compounds. Surgical solutions exist and do work.
11
Not everyone is willing to undergo surgical sterilization. Hormonal BC is good for those us who want to space our children out over time. However, they need to be better studied and made more efficient, with less side effects. I mean, it's only for 51% of the population, so I guess there's no money to be made?
7
Surgical solutions are not appropriate for teenagers, or for women in between planned pregnancies. And the surgery for female sterilization is no walk in the park. This is a very simplistic response to a person with multiple health issues.
There is a demand for non hormonal options that perhaps the author of this article could explore, in addition to seeking additional help with her other gynecological concerns.
3
It's very difficult, and in some cases impossible, for women to access surgical options. It took me 14 years to get a doctor to agree to sterilize me. Most said they won't do it until a woman is old enough she's a high risk pregnancy and has declining fertility anyway. I had to try and have adverse reactions to every birth control on the market, hormonal and non-hormonal. Even then, the doctor didn't want to do it until I pointed out I have a serious family history of mental illness and muscular dystrophy, so I shouldn't have genetic children anyway. I was in an extreme, unusual situation and still had difficulty accessing surgical solutions. This wasn't years ago, by the way. This was last month.
This article is spot on. Existing hormonal and IUD birth control methods work to prevent pregnancy but are fraught with serious issues. Consider that breastfeeding women are faced with virtually no good options for birth control either. All hormonal options can cause a decrease in milk supply, and the copper IUD causes a menstrual flood each month and debilitating pain. Guess over half the planet isn't a big enough market for Big Pharma.
33
Again: Diaphragm!
It’s good for people to become more aware of this issue. The birth control pill definitely lowered my sex drive back when I was in university, and I think it may have subdued my general mood. I wish I had known more about this at the time. For me, though, it was still absolutely worth it because I felt I could not risk a pregnancy and I wanted to be sexually active.
Women take birth control that has risks because the risks of pregnancy and childbirth are even bigger (death, incontinence, discomfort and potential illness in pregnancy).
The pill is really the gold standard for birth control. Everything else is either permanent or you are worrying. If you’re using condoms every late period is stressful. I don’t think that with the pill or diaphragms women could be sexually active and seriously pursue long term investments in education or careers because you just wouldn’t be able to be sure you wouldn’t fall pregnant. A lot of the opening of careers, education, and the public sphere to women has happened because of the pill.
2
IUDs are more effective than the pill. There's more room for human error with pills.
2
Oops. Should read “condoms” or diaphragm.
1
That’s interesting Blue Jay. When I first started using birth control there had been some serious problems with IUDs that I think have now been resolved. But good to be aware of.
A huge issue for me at one point in my life was irregular periods and that made the use of condoms very stressful — so much worry — especially because I wouldn’t have been willing to have an abortion (unless there was some danger or health complication).
For all its problems, the pill was a gift to me.
What an astute editorial. It raises many excellent questions, but preeminent for me as a young breast cancer survivor on hormonal therapy for ten years, Is this the best we can do for women in this country? The hormonal therapies that are across the board for most breast cancers (no matter the age) also have terrible side effects that seriously affect quality of life for many women. And, yes, for many years, the pharmaceutical companies and doctors as well did not admit to or acknowledge that debilitating side effects were possible. (Many women were told it was just in their heads. Sound familiar?) Perhaps we need some sort of #MeToo revolution regarding the drugs specifically targeted for women and their reproductive systems. We deserve better.
97
Women have to speak up! For far too long they have allowed themselves to be silenced by “authority” figures such as MDs - when your medical doctor fobs you off with the suggestion or outright statement that your symptoms are “in your head” it is time to get another MD -
1
I suffered from painful cramps from age 14 to 24. A guaranteed day in bed doubled over, no school, no work. A good month was when "it" showed up in the evening, giving me a hope of sleeping through the worst of it. In the 60's, many doctors (men) assumed it was in a woman's head. And the few females who didn't suffer made the rest of us look like drama queens. I tried Midol in college, but the caffeine made me jittery and kept me awake.
My first relief came in the early 70's. I had a great job at a major media company in mid-town Manhattan and couldn't go home when the "curse" arrived the first time. The company nurse (yes, we had one) gave me eight, tiny blue pills. I took two and felt so great I was able to attend a media event that night! Didn't need more, so I saved the other six. For a year I did the same - get eight, take two, save six. When I left that job, I had an 18-month supply. When they ran out, I was told that they'd been taken off the market because it had more than one active ingredient including an amphetamine. No wonder I'd felt so good!
Next stop was a gynecologist and LoOvral. It saved my life. No more cramps. I felt normal and free. I took it for about five years. Then I became pregnant and had a baby. When my periods returned, I never had cramps again, just headaches for awhile.
As for failed birth control, a dear friend had her tubes tied after four kids. Three years after, she was pregnant again. The tubes had grown back together.
9
The only time I ever became suicidal was after less than 1 month on Nordette - a pretty average OCP. I took YAZ and after a couple of months I became a zombie. Whoever says "depression might seem a small price to pay" a) has no clue about condoms and b) zero clue about depression.
93
Just as an aside to the asserted numbers on depression thrown in at the end, the author quotes a CNN article that in turn refers to another article, and includes a quote from a researcher talking about the numbers. Having read the articles the numbers are far from compelling, and the articles are written [ahem, this is CNN online we're talking about] to highlight big numbers and rather than provide useful information.
If you follow the link chain you will see that the research concludes that there is a "1.2... or 1.3-fold" increase in risk of depression among women taking oral contraceptives. So, there is a 20 or 30% increase in RISK for depression, not a 20-30 percent of women on oral contraceptives reporting depression. If the baseline risk is 1%, with oral contraceptives women now have 1.2 to 1.3% risk for depression. If a 10% baseline risk, then it turns to 12 or 13% risk.
But the article does quote the study to tell us exactly how many women on birth control report depression in a year - 2 or 3%! And that's for those between 15-19 years old, a group "more vulnerable to this risk than women 20 to 34 years old".
So, maximum case a woman on oral contraceptives goes from a high-1% or 2ish% baseline risk to a 2 to 3% risk. Not a particularly shocking increase, particularly when manipulating hormones.
Where the quoted professor got her info is not cited, so I have to imagine it was just fluff.
Just sayin'!
54
My bet is that most women who have depression while on the PIll don’t report it. Most people with depression don’t report it in any given year. Male or female. Whatever the cause.
Why? Quite often a doctor will diagnose depression & when the patient finally says, ok, what do we do about it, is told to go for long walks every day. I tried it, didn’t work. So the last time I said, ‘what if I can’t get out of bed to go walk, what then?’ Finally was offered an antidepressant. This took about 20 years. Mostly I didn’t talk about it & the doctor didn’t ask. Depression is still one disease that is all in your head. It is, since it’s a brain dysfunction, doesn’t mean it can’t be treated though. Depression isn’t in your liver, it’s in your brain. So when told it’s all in your head, stand up to your doctor & say ‘yup it is, now how are WE going to treat it?’ Don’t let ‘it’s all in your head’ scare you silent.
1
Quite possible, but still no reason to make numbers up. Instead of 20-30%, why not 10-20 or 50-60? You know, people sometimes don't report so why not?
1
I too got depressed with hormonal BC, I used a diaphragm successfully for many years and now have my tubes tied. If I were a young woman today, I'd choose a non-hormonal IUD.
Now this wouldn't help the author, who needs control of pain. She needs more research to be done into non-hormonal treatments for endometriosis. That is such a sad thing, since I know many other women who also have trouble with endometriosis.
7
If I was young again (oh God NO!) I’d have a hysterectomy, saving just my ovaries for hormones. WE knew we didn’t want kids. It would have been the best solution, but, both doctors & insurance felt they had a right to tell US we might change our minds. So, after The Pill made me suicidal we switched to condoms, were responsible & careful, & never had kids. Hubby’s family had another son to continue the ‘family line’. His sisters each had kids. One couldn’t afford even one,had 3. The other had 2, they couldn’t afford. But, all were raised, couples had babies. Period. They expected help from everyone else, because responsibility didn’t enter into it. Still doesn’t from what I’m reading. Maybe a return to no pills, no IUDs, no diaphragms would be a good idea. Hysterectomies, vasectomies, & condoms the only pregnancy protections. With responsibility as the operative word for each. Can’t be with condoms, pick the other two. Belt & suspenders. Every man & woman who can’t afford, for health or monetary reasons, to have a child, get sterilized. Or use condoms. There is NO Right to have children. They are all responsibility, If you can’t keep yourself from getting or making a woman pregnant, then you shouldn’t have that ability.
1
Women and Men who want surgical sterilization should be able to have it.
Endometriosis can be treated with hysterectomy. Women should have everything explained, with counseling about long term effects and should have a choice.
3
Hysterectomy has a host of side effects - not the least of which are sterilization (not a great option for younger women who want children) and early menopause (which comes with its own set of major problems).
7
Menosyne, hysterectomies are serious operations. Many young women who have endometriosis don’t know if they might want children one day. These issues are hugely complicated and there are no easy solutions.
11
Wow, that’s extreme, considering the author’s problems began in fifth grade. I hope fifth grade boys with scrotal problems or jock itch wouldn’t be told to have their testicles removed.
5
I know this film is about hormonal methods and one personal experience. But, just sayin...the old mechanical and barrier methods can be safely and effectively used to prevent pregnancy and sti. And some people swear by the non hormonal iud. If you are at a suitable age and stage, don’t forget vasectomy! I agree depression is way too large a price to pay. And it is not adequately warned about.
6
I sympathize with the writer, however this article is really about lack of treatments for endometriosis, not contraception (but maybe that title wouldn't generate as many clicks)? The writer used several forms of hormonal therapies to control the pain due to and prevent progression of endometriosis -- and these hormonal therapies happen to also prevent pregnancy. Her underlying conditions of endometriosis and chronic pelvic pain make her not an ideal candidate for the non-hormonal IUD, an excellent form of contraception for many women. She may also find barrier methods or even cycle tracking excellent ways to prevent pregnancy -- but those will not help control her pelvic pain. So, again, although it doesn't make as sexy a title, the writer's beef is with the limited options for endometriosis management, with which I completely agree, and not with the array of birth control methods available.
72
Depression is a serious medical condition and I'm sorry that the author has struggled with it. However, blaming birth control alone may be naive. HHS Public Access has a recent report on the prevalence of depression (Major Depression) among all women over 12 months: 23.7%, and lifetime: 38.3%. Men have similar but somewhat lower rates. As a retired psychiatrist, who treated 25,000 patients with 1,000,000 Rx, I am very familiar with the condition. The numbers for anxiety are even higher: 37.3 for 12 months, and 44.8 for lifetime. Clearly hormones have an important role in mood regulation, but the most influential hormone is the stress hormone cortisol. There is an extensive supporting scientific literature presenting the "neurotrophic hypothesis" of depression. Essentially, high cortisol levels in a stressed-out lifestyle (San Francisco?) suppresses, among other things, the development of new brain cells in the hippocampus deep within the "limbic" brain interior. My experience was that docs rarely know how to use anti-depressants properly (it takes two carefully matched agents to provide side-effect free complete mood relief) and the literature shows cortisol levels falling with anti-depressant treatment. If you'd like the details and references, check out the free PDF, "Stress R US" on the net. Just Google the title and re-enter it in the "library" search window on the MAHB website homepage. Good luck!
7
I am long past the age when I need to think about birth control, but I have heard that there are many treatments between birth control and hysterectomy which are said to improve or stop endometriosis. Perhaps the writer needs to switch to a female OB/GYN who is willing to listen and explore it from the aspect of fixing the endometriosis and then use a non hormonal birth control for actual birth control.
3
I would completely agree with this author, the serious side effects for women of birth control - and the willingness of those prescribing to overlook them - are not acceptable. Depression should not be under-estimated and it's worrying that women who already have to care for children and are taking birth control could be at risk of this. This article doesn't mention it, but the contraceptive patch is also associated with dangerous migraines and blood clots, as is NuvaRing. The manufacturers knowingly put women's lives at risk and pay out settlements to a small number who are affected to keep their profits and avoid public trials. https://www.theguardian.com/commentisfree/2015/jun/22/nuvaring-merck-dau...
Furthermore, the reasons why women and girls take birth control are many, and may be for treatment of disabling health conditions, not just to avoid pregnancy.
6
Thanks for this very important article. Like you, I, too have been allllll around the block -- from the pill to the paraguard and now to the Mirena. It bothers me that I have spent half of my life on hormones (minus my brief stint on paraguard) -- do I even know what it's like to feel like a regular person? My colleague, who is in her 50s, keeps pushing the diaphragm, which is what she and all her friends used back in the 80s. There is a newer model called the Caya I'm interested in trying. However, the non-hormonal options aren't always an option for ladies with endometriosis. Here's to hoping we can develop safe and effective hormonal and non-hormonal options!
5
I am Woman, hear me weep, and moan. Hysterectomy or wish for early Menopause. And you are absolutely correct, no Male could, or would, tolerate even ten percent of the side effects Women commonly experience using many medications. It's almost like it's not a concern, OR you must take more medications for the side effects. The Circle of STRIFE.
Best wishes. Also, wine. Just saying.
7
I have some mixed feeling about making a comment. I am an older male and while I have a doctorate, it is in science and engineering not medicine. Unfortunately,I have some experience in side effects. I had a daughter that was diagnosed as bi-polar and I have no reason to doubt that the diagnosis was correct but the medications came with one side effect after another. The first med caused a rash which was bleeding under the skin. The second which seemed to work caused sleepiness to the point of having to be ready to go to bed the moment you took it. She was given another medicine to combat this but it had other problems. Then she was given another medicine that promised to have fewer side effects but that medicine caused her to lactate. I remember her coming to me and saying she was not pregnant but I told her I knew that and told her that while your breasts might swell during pregnancy. you would not lactate until after giving birth. Then she quit taking most of the meds and went back to having bi-polar problems which unfortunately ended with suicide some 10 years ago. At the time she had taken some of the med that was supposed to make her more alert but which I later found also was linked to suicide. An unfortunate end to what had been a promising life. She was bright, athletic, and graceful.
41
I'm sorry for the loss of your daughter. Peace be with you and your family.
9
My condolences to you. Thank you for sharing your story.
5
I tried birth control pills for one week. I had increased migraines, almost every day, culminating in one that seemed like a mini-stroke with half my body feeling a little bit numb, impaired thinking and an inability to find words. When I told this to the college's health center doctor, I was the one to suggest going off the pill, not him.
Now I'm wondering whether doctors don't believe women's symptoms are real. Many illnesses that are more common in women, like chronic fatigue or fibromyalgia are initially treated as psychosomatic. Women who try to get help end up feeling like they are being accused of malingering or making things up. (I wonder why doctors think that millions of women would do this?) Later, physiological causes always seem to be found, after years or even decades of dismissing the suffering that may not be deadly, but can be severely life-restricting and physically and/or mentally painful.
As I write this it is beginning to seem like a form of emotional abuse for so many in the medical establishment to treat women this way. And it can cause lifelong medical harm. Women deserve the same respect for their illnesses as men. And everyone deserves better information about drug side effects.
http://www.independent.co.uk/life-style/health-and-families/health-news/...
36
As my husband, who is a physician, once said to me partly in jest: the problem with men is that they are forever “pre-menstrual” and don’t know what sanity reallly is.
Sometimes you have to educate your doctor. They don’t stop learning when they graduate, but, they can’t keep up on the new research in EVERYTHING. So, after I read an article about Fibro years ago, I researched it, printing out all the NEW stuff I found. Added a book I bought about it, that seemed reasonable, as too symptoms, if not treatments, wrote my doctor a letter (that boiled down to: if it walks like a duck, swims like a duck, & quacks like a duck lets see if it’s a freakin’ DUCK! Mailed it all to him. Gave him a few weeks to study it all, it was a lot. Then he called me. We talked symptoms for awhile, then he thanked ME for the time it took to do the research. Told me to make an appointment, & we’d try together to roast this duck. It’s still roasting many years later. I’m down to one script for it (flexeril so my muscles will relax at night, small dose), & Ibuprofen & Tylenol arthritis at night. Oh, now I have arthritis, occasional sciatica, so the Ibuprofen & Tylenol now help more things. See I convinced him that depression doesn’t cause chronic pain. Chronic Pain causes depression. I think it was the line that said: ‘How would you feel if you felt like me 24/7/365? Depressed?’ that did it.
2
I cringe everytime I read one of these stories of women suffering because of birth control pills. I have a story as well and want to extend my empathy to this author and the many others who deserve better health care and better birth control. We shouldn't have to suffer extreme side effects because we are trying to protect ourselves and our families. We deserve better.
25
So the author is unlucky that she gets severe side effects that most other women don't get. Tough luck.
The complaints about men's birth control make even less sense because the author took these pills not to avoid pregnancy but to medicate menstrual pain, something that is not applicable to men at all.
And not only men are refusing hormonal contraceptives because of the side effects. People are just much more aware of that now than in the 70s, just as with smoking. All my recent girlfriends refused the pill for that reason, and I could totally understand it. There are many other options, and anyway I just had a vasectomy done a few years ago to take care of the problem once and for all. Of course, none of this is any help for endometriosis. There, the choice seems to be between pain or depression. I'm not sure that is anybody's fault.
2
Your comment of "Of course, none of this is any help for endometriosis" renders your entire paragraph moot. She's talking about hormonal birth control specifically for endometriosis, which in her case, has the side effect of preventing pregnancy.
Your "tough luck" remark underscores how incredibly dense and uncaring the attitude that pharma (and folks in general) have toward methods of birth control, in general.
15
ALL hormonal contraception is toxic to a woman's body-and very often leads to depression. An important question to ask is why are physicians so eager to prescribe hormonal birth control when natural alternatives are available, and why physicians are so lax in explaining serious side effects? The answer is Big Pharma, and the lesson is that all women need to educate themselves in caring for their reproductive health.
6
WEll, most doctors probably expect you as a consenting adult will read the info that comes with the perscription & call if you don’t understand what it says. Since you read the NYT you should be able to read well enough to understand the insert. Oh, at least once a year, read the inserts again, carefully. They are updated with new information. I didn’t with an antidepressant I took for 30 years, so spent that long with IBS, that at some point they put into the insert as a side effect, so I never knew it. Now I suggest to anyone on a long term medication. Read the insert carefully & regularly, or you could suffer my fate.
My wife also suffered side effects from oral contraceptives, so we tried a novel idea -- birth control would be as much my responsibility as hers. Wow! What a concept. We did two things. We practiced the much derided natural family planning, which worked well for us as a long-term monogamous couple. I actually had to learn how my wife's reproductive system functioned and whether we were or were not up for having children, and we had to talk about these issues on a monthly (or more often) basis. It worked well -- we had the two children we wanted -- and it enhanced and strengthened our relationship. If abstaining from intercourse during her fertile period was unbearable, I used a condom -- something any many in any type of relationship could easily do -- without whining. Men need to take equal responsibility for contraception and everything else in a relationship. A lot of men think that sounds unbearable, but I found it oddly liberating.
142
Thank you for sharing your intimate story. You get it - we are all in this life together!
"Men need to take equal responsibility for contraception and everything else in a relationship. A lot of men think that sounds unbearable, but I found it oddly liberating."
YES - this is what we women want - engaged, committed, sensitive partners who are responsible and creative and find way forward together by communicating, with creativity, devotion and fearless exploration of all our needs.
Prosper!
8
Thank you, Scott. I am not sure why your letter isn't yet an NYT pick.
One thing that alarms me is the push to close Planned Parenthood clinics. This article, your story and many others, and your letter emphasize the need for them. I especially think that men should get out and fight to retain PP and as you did become much more involved in the responsibility for reproductive health and BC.
1
Thank you, sir! My guess is more men are taking responsibility for birth control only now that paternity tests are both available and affordable -- and accepted by the courts when awarding child support.
Interestingly, the entire endocrine system, all the glands in the body together, in total, only secrete about a teaspoon of hormones in a year. As such, it take only minuscule amounts of hormones to influence the entire endocrine system and all that that influences.
These steroidal hormones used in contraceptives end up polluting the water and the result is hermaphroditic fish, female lions growing manes for the first time in history, disrupted reproduction in domestic and wild animals, and those of the millennial generation confused about what sex they are and thinking there are 161 genders.
Here is a woman with a medical problem, endometriosis that causes her pain several days a month. Why not treat the problem with pain medication instead of systemic steroidal hormones? Would not low-dose opiates or other pain medications solve the problem in a less invasive and dastardly way?
Presumably Big Pharma makes more money by daily dosing women, fish, wildlife, water, earth with bio-active steroidal hormones that are causing disruption throughout the biosphere. Maybe it needs to stop.
11
I have endometriosis. While endometriosis entails crippling pain, that is not its only problem. I've received contradictory information from the various doctors I've consulted, but a common thread is that over time severe endometriosis could cause damage to your organs (the scar tissue, for example, can cause an organ to "stick" where it shouldn't) and the continual bleeding from the endometriosis causes inflammation and pain. The goal isn't only managing pain, but limiting the progression and bleeding of the endometrial tissue. That's why doctors are prescribing hormones; pain management is not enough, and given the high risk of abuse for prescription pain killers, they aren't a good option for chronic pain sufferers. While I expect that your comment was well-intentioned, endometriosis is a confusing, insufficiently researched disorder and it's difficult to find reliable medical advice; uninformed treatment suggestions are part of the problem.
For others who may be reading these comments for advice, I quit all hormonal interventions because I couldn't tolerate them, and have found decent pain management through an anti-inflammatory diet working with a nutritionist, pelvic floor physical therapy, and acupuncture (none of which are covered by my insurance). My doctor expects that I may eventually need a second surgery because I am not using hormonal birth control to limit the endometriosis.
1
Tried low dose opiates for menstrual pain many years ago. They were good. I’d save ones I got for having an assessed tooth root canaled. Finally ran out. No respectable doctor would give me more. Too much danger of addiction. Opioids do not really help any chronic pain, & are more often contraindicated, when you go off them, the pain is worse. Oh, someone suggested wine. My mom said her Dad (a doctor) suggested warm sherry (blah!), taken as a dose of medicine, starting in the morning. I prefered tequila & orange juice (a little grenadine) over ice. Worked. So I added more, figuring it would work better. Well, now am 27 years sober, lived through the pain, & other pains, without having to start drinking or taking opioids, again. Never will. Well, if I get bone cancer, & a doctor that knows about addiction prescribes it, I just might. I’m not brave enough to take that cancer cold with nothing as a man I knew, sober many years did. It is said to be the most painful cancer there is. He did it sober. If he can do that, I can handle chronic pain with OTC pain meds in doses prescribed by my doctor. Even as they start to grow atop one another.
It struck me that the study was Danish (European) and not American. Why aren't American researchers looking into both side effects of birth control and looking for a better birth control method with fewer side effects?
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No one is funding them. Not mostly male congress. Not mostly male run Big Pharma. Nobody.
2
My experience with oral contraception was very similar and so I gave them up as soon as I realized what they were doing to my head/emotions. It doesn't matter if you are taking them for pain or birth control, of course -- any medication that is so widely used should be better designed to preserve the whole health of the patient.
5
With most medications, like BC medications, if they waited until they were perfect (no side effects, cured every ailment, etc), there would be no medications for anything on the market today. NONE. We are humans. Nothing we do is perfect. But, many people think that every medicine they take must be perfect, no matter how they take it, no matter what their particular constitution is. This is not possible. So I suggest you stop all medicines, stop going to the doctor for anything but broken bones, & sit back & wait for death. With no help. Cause no medicine is perfect, no treatment for anything is perfect. Oh wait, that means for broken bones too, so don’t even have them treated. Medical researchers don’t go out of their way to ‘design’ a treatment to treat the ailment but make you sick in some other way. They find something that works, not perfectly, but, does more good than harm. They do their best to minimize side effects, but, can’t get rid of them all, or even find them all until it is in general release, as studies don’t include millions of people. They do their best. Sometimes when more is known a medicine is updated, which lessens side effects, sometimes a side effect is found that makes them pull it from the market, even if it works perfectly for you. You scream then too I bet.
Married for 42 years. My physician wife was never ever willing to take oral contraceptives. She had to for one month when she had an ovarian cancer scare and it had all kinds of negative emotional effects. The Author deserves massive sympathy and I would hope for better treatment for endometriosis. But effortless & riskless contraception is not on the horizon for men or women. I put the effort in. Whats wrong with the guys out there?
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Key fact here: 3% of the men who were in the male contraceptive study experienced depression. Thus, it was halted.
20-30% of women taking contraceptives experience depression, and must take medication for it. WHAT IS WRONG WITH THIS PICTURE? Let's please reinstate this study for male contraceptives...
15
I understand fully the author's reason for using hormonal birth control. It was not something I could ever imagine doing, though. I never wanted to mess with my hormones.
2
Some people will take anything as long as it minimizes their pain. In other circumstances, they are called addicts. I came to the conclusion long ago that it is cessation of pain that is the most addictive thing in the world. Most of us will run after that most of our lives. Try any substance & if it works even a little, demand it for life. Then tell the world that substance is NOT addicting, they must be allowed it, whenever, however, & for as long as they want it. Because one day it worked for a few hours & they had a total cessation of pain. They are mostly right. It’s not so much the substance that is addictive, though it can become physically needed, it is the cessation of pain they get for a short while that is mentally addictive, so they keep taking more & more until they are either stopped or die. The worse the pain, the more likely the person will become addicted. Lack of pain is the be all, end all, of medicine.
Alas, the Op-Doc video of Sindha Agha's struggle with endometriosis side-effects didn't come through - and we viewers were left with a a static red ad for Hunt's petite diced tomatoes and a recipe for penne with fried eggplant instead.
Sinda Agha's story is similar to those women (and men) who have suffered from Myalgic Encephalomyelitis (aka Chronic Fatigue Immune Dysfunction and Systemic Exertion Intolerance Disease - the CDC definition, Lord save us. i.e. Good luck from docs on their diagnosis and forget healing by Big Pharma medications. Holistic Medicine is a better venue than docs who consider CFIDS, etc. wastebasket diseases.
1
I am so sorry you have experienced such a hard time in seeking treatment and relief from endometriosis. However, birth control pills are, overall, very safe and effective at preventing unwanted pregnancies and treating other gynecological conditions. The pill is far from perfect - but it's very good and effective. I'd say the real bias comes in with hormone replacement therapy (HRT)for menopausal women which does not effect men at all - vs birth control pills from which men benefit by not having unwanted children. HRT options are very few, extremely expensive and deemed medically optional with very little research.
4
FYI you can suffer from hormonal depression and NEVER EVER take the pill. It's called PMS. At 24 your brain has not yet reached maturity -- that's at age 26, and then decline sets in around 29 for mathematicians but you won't really experience it until you hit the biig 40. I suffered from depression and became much happier at 40 for awhile (Life begins at 40), because one can't have as many things on his mind at one time as before one was 40... Then PMS set in with me feeling OK half the month and depressed the second half. Much later in life, my 60's, I became depressed requiring hospitalization and eventually underwent electro-schock therapy which my 102 year old aunt had had in the 1960s. Since then I am not depressed but when one is over 70 one begins to appreiciate whatever life is left knowing full well that it is transient.
Nonetheless I would recommend electroshock at what age?? rather than antidepressants one of which gave me canker sores for 9 months until I stopped the drug. Not long thereafter I was banned! from my helpful therapy group of two years, having reported an agreesive social worker for bullying not stopped by the MD supposedly in charge.
My advice find a therapy group with a kind social worker and an MD who intervenes at the first sign of any bad behaviour. If it's called cognitive therapy (Payne Whitney) make them define it. (One can do WEB research.) Report abuse to to administrator and then insurance company if no positive results.
1
I want to add that when I hit menopause I was thrilled... age 52,, usually. but then began the night sweats, hot flashes and following an endometrial biopsy -- it hurts... a lot- a colonoscopy sans anethesia is nothing comparatively painwise fyi -- so I was put on prempro-- which I dosed as half pills, three times a week...Then the news came out about Prempro and heart disease (for which I am a candidate given the family medicalhistory) so time to go off Prempro.. Eight months later I was finally pain-free, except if I drink too much red wine or sometimes with weight-loss, the release of estrogen stored in fat, can result in a night sweat.
One person's experience with various conditions and the medical system as is. Hormones make problems that is for sure .. One commenter pointed out the effects on other creatures of hormones in our water sources ..and then there's over population. Depression is not esp well understood as a disease.... I think in a society where people have few friends (cell phones do impede interations with "strangers' -- which mom warned you against as well -- that group therapy or support groups (aging in place for oldsters) can be very helpful for our well being. People who feel better psychologically may be able to ignore chronic pain as I did for 10 +years (painkillers worked wonders for a month, then a week, then I quit them unless necessary) until I was about 20 years out from the end and had the surgery and I didn't finish the opioids.
This article/film is my story! ...except I stopped keeping track of the different meds, doctors, and mental struggles I experienced beginning at age 12. I cringe at some of the meds I tried, along with the horrid mood swings my husband endured. One particular problem-solving doctor told me to just have a baby. I remember my head spinning as I tried to fathom having a newborn baby AND the crazy and painful mental monthly business I went through on a regular basis. Yikes. Unless he had a magic ball, how would he know I would be "all better" with a baby...and how unfair to baby if I still felt so awful!?
A hysterectomy at age 32 took away my having kids...but it for sure saved my life and my sanity. My heart breaks for women who deal with endometriosis and who do not have hopeful solutions. We all deserve better.
6
While I wouldn't recommend that anyone have a baby to cure menstrual cramps, it did have that effect for me.
One of these days Americans are going to realize that medical science is mostly a crapshoot. And even with drugs that do work, there's a bell-curve associated with them: They work for most people, say more than half. But there will be some outside that "most" - and you can't tell who they will be just by looking at them. Nor will Obamacare remove the bell curve. Nor will the FDA.
Of course, because the FDA forces drug manufacturers to operate in a schematic fashion, requiring on average 12 years of research and testing, there are necessarily fewer drugs approved for humans in this country, and only about 1 in 5,000 get approved. The author's painful periods might have been fixed already but for this draconian practice. No doubt someone will comment that the FDA is protecting people that drug companies would otherwise kill with malicious drugs. I believe that the author should be free to decide whether to take a particular medicine, and get the FDA's leprous inept hands out of the process. But that's because I like freedom, and I have the ability to think rationally.
1
I would not blast the FDA. Side effects even from approved drugs can be life changing and NOT in a good way. Lots of stupidity in terms of what people around us say.. (Use red rice yeast (a statin with varying doses) not a statin prescribed by your MD. Black Cohosh for cramps and menopause -- yikes that one made me very sick.
With the possible exception of marijuana... and I am pretty sure that it is not great for developing brains but maybe it's OK... I have no idea why people even enjoy that buzz-- I am a strictly alcohol woman -- it does make me relaxed and sleepy.... I think the FDA but not CONGRESS does a pretty decent job most of the Time. Sackler did get his opioids approved-- a failure as with Abilify which can cause tardive dyskenesia -- pretly horrible and not reported initially.
I sympathize with you. Any birth control I have tried in the past 10 years causes an intense flareup of my interstitial cystitis. I deal with intense (and unexplained) menstrual pain each month with unhealthy doses of Aleve and Tylenol. I wish there were other choices.
5
I found alcohol somewhat helpful.
1
So did I. With no family history of Alcoholism. However, one ‘dose’ led to another (if one drink helped, 2 would help more, & so on). I don’t think Alcohol is good to suggest to anyone, just like you wouldn’t suggest self dosing with opioids, now would you? 27 years sober. I wouldn’t suggest alcohol to my own worst enemy.
This piece goes to illustrate an overarching theme that is sadly swept under the rug: the inattentiveness to women's healthcare. How many women have sat in an MD's office with a debilitating ailment and simply been written off as a "hysterical female"? The plight many women go through simply to be taken seriously - and then to be fitted with a one-size-fits-all cure they are told to feel grateful for - is overwhelming.
We owe women better research.
Better options.
Better treatments.
Better listening, and better understanding.
9
Americans have become medical guinea pigs. My husband was given meds by a Cardiologist that made him depressed. Thankfully I’m a retired clinical psychologist, looked up the medication and saw that for 30 years this drug was known to cause symptoms of depression. I spoke to a Nurse Practicioner in the Cardiology Dept, explained his symptoms and onset after taking the drug for only 10 days. She gave us permission for him to go off it. A weekend without the drug and he was normal again!
I’ve met patients whose drugs landed them in locked psych units. For problems which had nothing to do with psychiatric diagnoses.
My husband refused a drug for his lung condition that costs nearly 100,000 dollars a year. In Spain, his brother was given the drug for about a quarter of the price, paid for by Spain’s medical plan. But his brother ended up in the hospital with complications! We’d known some of the side-effects. But not what happened to his brother.
For many reasons our doctors push meds. Often without even warning the patient. They never believed us when we complained that Coumadin was leaving my husband a basket case, but sure enough, once offthe Coumadin, he improved.
Guinea Pigs we are not! Thanks to those doctors who listen to patients, inform them, don’t treat them like children to be dosed and left to suffer.
My sympathies to the writer. This is a dreadful disease. And too many women who have it are treated as psych patients or given meds that do the same.
14
Thank you for this article - I'm lucky to not suffer from cramps, but I've never been able to find a hormonal birth control that doesn't take me on a roller coaster of emotions. Doctors have not been particularly sympathetic; instead, I find the best source of information about new contraceptive from my friends. Still, that doesn't stop most doctors from trying to pressure me take something. At the end of the day, birth control is literally not worth it for me - especially if i'm not 'active.' for more information, I recommend Lara Mark's Sexual Chemistry, a history of the pill. Thank you, NYtimes, for publishing these op-eds - they help me not feel so alone.
52
While I can sincerely sympathize with the author and her disability, the majority of women using birth control are not avoiding intense pain, but do not want to bring a life into this world that will require their care for 18 years or more. Depression might seem a small price to pay to avoid this fate.
37
Barbara Harty - your sentence "Depression might seem a small price to pay to avoid this..." is so dismissive of the torture of depression that it's hard for me to believe you thought this through. You do know that people kill themselves at a significant rate to avoid that pain? Please talk to any nearby psychiatrist or psychologist or really depressed person to find out how "small" the price is.
87
"Depression might seem a small price to pay to avoid this fate." You're kidding, right?
66
Even with that in mind, responsible birth control should not have to including life-altering depression. And I say that as a mother of four planned children. It took several rounds for me to find hormonal birth control that didn't make me feel out of control or buried under a wave of misery and depression. You can't be an effective mother if you don't even have the willpower to get yourself out of bed.
13
This is so similar to my story. I gave up on finding a hormonal contraceptive that didn't make me crazy years ago. Coupled with various allergies there is literally no reversible birth control that works for me, and it still took me until age 32 to find a doctor willing to sterilize me. If I had been a man it would have been sorted out in my early 20s.
134
Me to. I explained to a chiropractor how I was feeling and he said I should have my T level checked. I did. It was very low but with in range, no treatment required. I had to pay for the lab by the way. Fast forward fifteen years and men’s well being clinics are all over the place. Two thousand bucks later I feel great my T level is right in the middle. My regular doctor refused to treat me and the insurance wouldn’t pay for. I quit the treatment because it was to expensive and they say it causes heart issues. Still have the problem. That easy for men?
Probably before your time but the feminist used to say if men got breast cancer they would find a cure. Fifty years gone by is it true? Was it then?
4
As a doctor who performs vasectomies I can assure you that men also face significant barriers to obtaining sterilization if they have no children or are 'too young' by the arbitrary standards of their physician. Since I feel like all adults who can be entrusted to raise a child or join the military can also make the decision to not have children I see many, many of these men who have been seeking vasectomy services for years - sometimes with unintended pregnancies that resulted in children or abortions as the unfortunate result.
14
No indeed estrogen/progestogen OCs, implants and IUDs are not for everyone. That does not negate the fact that for many they work just fine. What they do, in effect, is to mimic the conditions of early pregnancy, during which -- in nature -- ovulation ceases and the cervical/vaginal tissue secretes substances that impede further sperm entry. They only can mimic, and are not the real thing. Some bodies are more sensitive to that than others.
I am glad that you persevered and found a solution to your need. Kudos.
Actually many in generations preceding yours managed family planning quite effectively by what was known as the barrier method and even without resort to surgical procedure. We actually did! Hard to believe?
1