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Evening Standard
Evening Standard
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Emma Loffhagen

OPINION - Let's face it; there are no good contraceptive options

The pill has unforeseen side-effects (Tim Ireland/PA) - (PA Archive)

Last week, while waiting for a friend in the pub, I was doom scrolling on Instagram when a New York Times graphic flashed up on my screen. “More research links IUDs to breast cancer risk”, the headline read, above a shadowy-looking picture of the T-shaped device that I, along with 159 million women, have lodged in our uteruses. I quickly skim-read the article, phrases like “40 per cent higher risk” and “long-established link” ringing like alarm bells as I sipped my wine. I knew that, in theory, I should be concerned. But I simply couldn’t muster the energy. 

The details of the report are complex but nevertheless worrying  – a study published earlier this month found that women using contraceptive IUDs using the hormone levonorgestrel are at increased risk of breast cancer. The research looked at 78,595 women in Denmark between the ages of 15 to 49 years who used the IUDs, known by the brand names Mirena, Liletta, Kyleena and Skyla, compared to women with similar profiles without IUDs. Those who used levonorgestrel IUDs had a 40 percent higher chance of developing breast cancer. (Despite this, breast cancer remains rare among women under 50, and extremely rare for women under 30). 

It is not the first time that links have been made between breast cancer and the hormonal coil. A similar report was published in March last year. Then, as now, I couldn’t face dwelling on it. Because what, after all, is the alternative? A cavalier response, perhaps, but it is indicative of a general malaise that exists surrounding contraception. It is already such an exhausting minefield for women that news like this simply flies under the radar, filed under the general baggage of “women’s healthcare issues” that we are forced to navigate throughout our lives.

I don’t know a single woman who is even remotely satisfied with her contraceptive method

The horror stories just within my own circle of friends are enough to put even the most robust among us off their dinner.  Whether it’s having your coil fall out on the toilet, passing out during a coil insertion, going blind in one eye due to complications from the pill, having chronic pain for five years or falling into a suicidal depression on the pill, I don’t know a single woman who is even remotely satisfied with her contraceptive method. 

The study, ironically, comes as a new report from the British Pregnancy Advisory Service (BPAS) this month also revealed that one in seven women are unhappy with the side effects of their current contraception. The truth, at least for the moment, is that there are simply no perfect, or even good, options. Every method, it seems, is accompanied by some ghoulish unforeseen side effect, while we face an under-researched guessing game of throwing things at a wall and seeing what sticks. 

Were a medicine rolled out at scale to men subject to such widespread and potentially dangerous side effects, I struggle to believe it would be treated with such insouciance. While hormonal contraception clinical trials began in the 1970s, there is still nothing on the market. Why? Numerous possible methods have been proposed, but each has eventually met a brick wall, written off due to undesirable side effects that are extremely common in female versions. Naturally. 

It is an immense privilege to live in a country with safe access to reproductive healthcare. As similar rights are being rolled back across the world, it can feel ungrateful and frivolous to complain. But we must not let this be an impediment to legitimate and important criticisms about the safety of the options we do have.

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