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Contraception Conversations: "It’s a strange state of affairs when I consider myself lucky to get sick."

Fri 28th February, 2020

Reviewed by: Dr. Vamsee Thalluri

Tidings was made to open up the conversation on women's health, and for many that involves a confusing journey around contraception. It's something a huge chunk of women use, but is often only talked about amongst friends or with the doctor. Contraceptive Conversations is a running series that aims to open up the chat around contraception and just how varied everyone's journey can be.

If you have a pitch for Contraceptive Conversations, please send an email to Tidings@kinfertility.com.au

"Alright, let’s do your blood pressure then."

My doctor straps the pressure bag around my upper arm and presses the button to start inflating it. As it inflates, she asks me how I’ve been feeling. “Good” I reply. This is standard procedure.

Once a year or so, I head to my doctor for an appointment that is purely to get a new prescription for the pill I’ve been on for almost ten years.

She asks me a few general health questions, takes my blood pressure, ticks a box, prints off a new prescription, and away I go.

In 2015, the Therapeutic Goods Administration’s Advisory Committee on Medicines and Chemicals Scheduling, Australia’s drugs regulator, considered making contraceptive pills available over-the-counter. Despite allowances for medical conditions, the proposal was ultimately shut down, partly due to fears that the pill might be masking health issues.

Late in 2018, the issue was raised again when the Victorian opposition committed to making the contraceptive pill available over-the-counter if elected to government. The discussion was quickly snuffed when Labor took out the election.

It’s a strange state of affairs when I consider myself lucky to get sick. There’s something wrong when I am trying to time my doctor’s appointments to fit in with my prescription renewals. But the truth is, most of the time, I’m not sick. Most of the time, I’m making an appointment purely for someone to check my blood pressure, ask if I’m feeling well, sign a piece of paper for the pharmacist, and send me on my way (minus the fee for the appointment).

The Australian Medical Association has repeatedly spoken out against over-the-counter contraceptive pills, claiming that women need to see a doctor in order to be properly assessed and to encourage them to have pap smears and sexual health screenings. They feared that women might not recognise warning signs of potentially harmful side effects.

While I can understand that there is a desire to ensure women are taking medication safely and without detriment to their body, I’m sick of people assuming I wouldn’t recognise when my body isn’t healthy. I know my body very well. I’ve been living in it my whole life. I know when I’m feeling unusually bloated, when I’m getting headaches more often than usual, when there’s pain that wasn’t there before, or when I’m tired more than seems normal. I have, in fact, gone back to a doctor after switching pills for this very reason!

It’s a strange state of affairs when I consider myself lucky to get sick.

It has been widely documented that women are more likely than men to visit their doctor during the early stages of feeling unwell to prevent an illness from getting worse. To me, the suggestion that women are unable to understand and acknowledge their own bodies is somewhat condescending.

I also find it hard to believe that pharmacists, who are trained to understand what the various side effects of the drugs they sell are, would not be able to recognise the warning signs when I say I’m getting a lot of headaches. Particularly after I’ve recently started taking the pill or have just changed pills. Anyone with an ounce of intelligence would think to question whether their medication might be affecting their health, let alone a trained health professional.

As for the appointment being a useful way to ensure women receive their sexual health screenings: not every woman in Australia is on The Pill. Does that mean those women will never get a sexual health screening simply because they’re not renewing a prescription? Most women only need to receive a pap smear test every five years. I’m sure there would be other doctors appointments in that time where my doctor can suggest I have a sexual health screening.

There are numerous other barriers to sexual health screening, like remoteness and cost, which can be addressed rather than suggesting that the only way women will get their screening is if they wish to take The Pill.

Access hasn’t gotten any easier in all the years I have taken The Pill. I started taking the pill for health reasons unrelated to contraception. Now I take it because I am in an adult relationship and I don’t want kids. As I look at the continued debate around this issue, I can’t help but recognise all the other debates going on in the women’s health space. It would seem that when it comes to women’s health, our bodies are still not our own.