'I'd rather have a baby than crazy side-effects': how birth control is failing women

28 May 2017 - 02:00 By Pearl Boshomane
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Although a number of studies have been conducted over the years, not enough is known about the effects of hormonal birth control on women.
Although a number of studies have been conducted over the years, not enough is known about the effects of hormonal birth control on women.
Image: iStock

70% of women in South Africa are on contraception, but hormonal birth control is still far from perfect, writes Pearl Boshomane

"Yaz drove me crazy." These were the words uttered by a friend who said the popular brand of combined oral contraceptive pill had turned her into an emotional wreck. "I would kill a fly and cry about it," she said.

For many women, using hormonal contraception is not just about protecting themselves from unwanted pregnancy. Often they have to choose between what's more important: avoiding pregnancy or having control over their weight, moods, emotions and mental wellbeing.


Although a number of studies have been conducted over the years, not enough is known about the effects of hormonal birth control on women.

A recent study by the Karolinska Institute in Sweden (published in the journal Fertility and Sterility) found that an unnamed, popular brand of oral contraception reduced the quality of life of the women taking it.

The women (who were not told whether they were on contraception or a placebo) reported that their mood, wellbeing and energy levels "were affected negatively by the contraceptives". Yet surprisingly, the researchers noted that "no significant increase in depressive symptoms was observed."

Women we spoke to had something different to say, however.

For Nikita, the pill aggravated her existing depression. She said: "I have been on plenty of different brands and they all made my depression worse and worse. With an existing condition, it exacerbated an already difficult illness. Since being off the pill, I've been much better."

Anita said that while she used the Triphasil pill the side effects were "awful". She changed to the patch, then the injectable (Depo-Provera, which resulted in weight gain) and then the implant.

"My period was wonky - sometimes I would bleed for two months straight and then go three months with no period. I ate my fridge empty [and] my depression got worse. There were times when I could not get out of bed," she said.

Her hair also began falling out. The side-effects lasted for 18 months, until she decided to remove the implant because she "just could not take it anymore ... So now I am off all contraceptives and would much rather have another baby than have all these crazy side-effects."

After Phumeza gave birth, she went on the injection (she couldn't say for sure which brand it was). "I had the worst-ever side-effect: I bled every day for six months. Periods can be a nightmare as it is but here I was waking up to this nightmare every day. I eventually went to my gynae who put me on pills to make it stop," she said.

Sexual health and reproductive justice advocate Dr Tlaleng Mofokeng said that contraception side-effects were often deal-breakers for many women. "They can completely turn someone off contraception altogether. Or you'll find someone who is jumping from one [contraceptive] to the other. In the space of a year someone can go through five or six different types. And it really all boils down to the side-effect profile," she said.


According to the South African Medical Journal, 70% of women in South Africa are on contraception. The most common injectable is Depo-Provera, which the World Health Organisation has warned may increase women's risk of contracting HIV and may also affect bone density.

Bayer, which makes the Yaz, Yasmin and Ocella pills, amongst others, has settled thousands of lawsuits filed by women or their loved ones who complained the products had caused blood clots, gallbladder disease, strokes, heart attacks and even death.

Aside from women's mental and emotional suffering, there is another side-effect. Thenji said while her experience with the Yasmin pill wasn't all bad (she's had fuller breasts, great skin, less period pain and more regular periods), it had also affected her libido.

"I stopped taking [the pill] for about a year between 2014 and 2015, and my libido came back with full force. I always felt 'subdued' but I didn't realise that that pill was eating my sex drive ... I'm getting to an age where I'm realising that I won't have a strong libido forever and I don't know if it's worth it to squash it in my prime."

Mofokeng said medical practitioners needed to inform women more about the kind of contraception options they had and how they might affect their bodies. This would empower women to make a choice that was correct for them.

"A lot of women would probably be willing to stay on a contraceptive if they had the proper counselling ... Women need to understand how it will affect them. Everyone's body is different. Our desires for future fertility are different. We may have other gynaecological problems like fibroids or endometriosis, you could have other risks for cancer, you may be a smoker, you may be obese or overweight - so there are a lot of reasons certain people end up with certain contraceptives. Just because it's OK for one person doesn't automatically mean it's OK for you."


The general lack of education around contraceptives was a problem, she said, especially when it came to what contraception poorer women had access to. Triphasil and Depo-Provera are often given to women who can't afford contraception.

"It's almost like there's a targeted campaign, 'Just make sure that you control these women's fertility rates. Give them Depo-Provera because it lasts longer and our clinics will be less populated with people coming for contraceptives.' Some of the reasons certain options are given have got nothing to do with good outcomes. It's all about economics.

"[As a woman] you don't get the information you require to make informed decisions - it's almost like the decision has been made for you, and you must choose if you're in or out. And if you're out, you also get judged for falling pregnant."

For a long time the responsibility of not falling pregnant has often fallen on women, but it seemed things were changing when researchers began testing options for men. Last year, a clinical trial found an injectable contraceptive to be effective in 320 men, but the trial was stopped early because some participants complained about side-effects - libido, depression, acne and mood swings - that women have been experiencing for years.

Mofokeng said the side-effects of contraceptives for some women affected their right to control their bodies and their reproduction. "Women choosing if they want children and how many they want, and how they want to space them - that's one of the fundamental human rights. Women need quality options. We deserve quality options. It's our right to have quality options."

*First names have been used for privacy.

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