Mary Pelton started taking the contraceptive pill in 1969. Back then, it was still fairly new and something she describes as ‘an absolute breakthrough’.
In upper sixth form at the time, the then-teenager had been prescribed it by her GP as treatment for irregular periods.
Now in her seventies, Mary recalls how it felt ‘exciting to be safe from pregnancy’, as sex education at school at the time focused on all the possible negative outcomes of sex and sexuality rather than any positive.
‘The GPs were also excited to offer women a reliable contraceptive as they often dealt with the consequences of unplanned pregnancy and backstreet abortions,’ she remembers.
It’s been over six decades since the early contraceptive pill Conovoid was given to women across the UK – something later seen as a move that changed the landscape of feminine health forever, and is a subject of discussion on the latest episode of Metro.co.uk’s podcast Smut Drop, with guests Rikki Lake and Abby Epstein.
Here, in the UK, initially only married women could be prescribed it through the NHS, however, not long after the pill was later made available to singletons, Mary felt it became ‘expected’ that women would be the ones taking sole responsibility for contraception.
‘So many fell pregnant using condoms and the Cap, or the rhythm method,’ she explains. ‘[The advent of the pill] then led to the “free love” movement where single women having premarital sex became the norm, and glamorous too.’
GP Dr Sarah Jarvis says that there’s no doubt the pill’s impact on society has been gargantuan – arguably even bigger than ‘any other medication in the history of medicine.’
So many women fell pregnant using condoms and the Cap, or the rhythm method
‘The fact that, despite the thousands of types of tablets prescribed every day, everyone knows what “the pill” is speaks for itself,’ she says.
‘It’s hard to imagine that before the invention of the oral contraceptive pill, no woman could be reliably in control of their own fertility. The advent of the contraceptive pill caused seismic shifts in women’s abilities to determine their own destinies and to have their own careers.’
According to Sarah Toler, science content lead at period tracking app Clue, the availability of the pill was crucial for giving women the independence to enter the workforce en masse – and earn their own money in a way many had previously been unable to do.
‘Personal income allows women to leave violent situations, invest in their futures, and provide a better future for their children,’ she explains.
‘Another lesser mentioned impact of the pill was the ability to have premarital sex.
‘Sexual pleasure is a human right and integral to our hierarchy of needs. The pill granted women access to participate in human pleasure without dire consequences.
‘Wellbeing is improved when all of our body’s functions are available to us and under our control.’
Talking about her own experience taking the pill from age 17 for painful periods, Sarah says: ‘I’m very grateful for the pill because I was able to focus on my education and career instead of worrying about becoming pregnant.
‘I’m also thankful for what it’s done for the generations of women in my family who are business owners, educators, and academics.’
Claire Hattrick can still recall the churning sensation in the pit of her stomach as she sat in the car outside the sexual health clinic.
It was in the summer of 1983 and, at the age of 16 and in a long-term relationship, she was ready to go on the pill.
‘You didn’t often go to the GP back then,’ she remembers. ‘You had to go to a special clinic. My mum had no clue what I was up to. There was no way we would have discussed something like that. Teenage girls lived in fear of getting pregnant, as it would have brought huge shame on their families, yet we didn’t discuss with them how we stopped it from happening either… I imagine they just hoped we weren’t having sex.’
Claire is now 53 and has 23-year-old twin daughters. She says it’s hard to believe just how much the conversation surrounding the pill has changed over the years.
‘When my girls were ready to go on it, they told me straight away,’ she says. ‘For them, it is simply about taking responsibility, so why wouldn’t I want to know about that? However, when I was younger you just didn’t discuss it with your parents.
‘I found out about the pill from friends and magazines, and it was something we all took as soon as we started having sex. It was drummed into us as being the only reliable form of contraception, so we didn’t look at other options. Back then, if you had an unplanned pregnancy when you were young, not only would it heap huge shame on your family, but it was seen as something that would ruin your life. There was no sense that you could be a single mum and still have a successful, happy future.’
‘Getting the pill from the Family Planning Clinic in the 1970s as a single girl meant facing questions from a matronly doctor about our relationship, whether we were engaged and when we planned to marry,’ adds Mary.
‘We were made to feel embarrassed as we had to pretend to such plans or be judged promiscuous.’
In fact, Claire, who runs the female support blog Clipboard Claire, says it took a serious car crash for her to finally admit to her mum she was taking the pill.
‘I was stuck in the front seat and my head had banged the dashboard. I remember the paramedics saying I needed to go to hospital and that they had called my mother,’ she remembers.
‘I began to panic that she might be told what medicine I was taking, so when she arrived I blurted out to her. Of course, she was more concerned about whether I was going to be okay. But still, we never spoke about it again.’
With reported side effects ranging from irregular bleeding, breakouts, nausea, headaches and hair loss to mood swings, reduced sex drives, blood clots, anxiety, and depression – to name a few – the pill, while revolutionary, is still not perfect.
Using it for nearly 15 years until she decided to start her family, Claire says that she can’t remember suffering any issues, unlike one of her daughters, who has to deal with monthly mood swings.
‘But then I wonder if it was a case of just putting up and shutting up,’ she says. ‘We didn’t have the variety of pills women have now, and we weren’t warned about potential side effects either, other than the warning it could lead to certain cancers. So I do now think maybe we just put anything it did cause down to something else?’
Alice Pelton, Mary’s daughter, started taking the pill at the age of 16 when she first started having sex.
However, she soon discovered it impacted her moods – for example, when Amy Winehouse died while Alice was on a work trip, she couldn’t stop crying around her colleagues. ‘It was so embarrassing,’ she remembers.
Alice, now 33, spent the next 10 years battling to find a form of contraception that worked for her, eventually landing on the non-hormonal copper IUD.
‘Everyone thought I was very moody and emotional,’ she says. ‘But when I came off Microgynon about three years later, I started to wonder whether my pill was to blame. When I was on it, I would get these uncontrollable outbursts and cry at really stupid things – but all that stopped a few months after I stopped taking it.
‘Like many women, I spent the first years of my reproductive life terrified about getting pregnant – but weighing that risk up against the side effects I personally experienced on hormonal contraception was really difficult.
‘When I spoke to my GP about this, I felt ignored and frustrated and like I was being gaslit about the side effects I was having.
‘There is such a depressing lack of data, expert advice and support for women like me trying to navigate their options,’ adds Alice.
So, frustrated by her experience, she ended up creating a contraception review platform called The Lowdown, which now has garnered over 5,000 reviews from people sharing their experiences – like Jasmijn Ouwendijk, from the Netherlands.
I started to suffer from weight gain, horrible moods, and I did not feel like myself
Jasmijn is one of the 14% of women who started taking the pill for reasons other than avoiding pregnancy – such as having lighter periods, improving the symptoms of PMS, making cramps less painful, and treating conditions like polycystic ovary syndrome and endometriosis – but for her, it was ineffective.
‘I started with the pill as a 16-year-old who was keen to “control” her period and have fewer side effects,’ recalls Jasmijn, 22. ‘My doctor was happy enough with that and prescribed it to me.
‘However, the exact opposite happened: I started to suffer from weight gain, horrible moods, and I did not feel like myself which made me go on and off the pill for several years.’
‘I think it was the thrush and breast tenderness that stopped me taking it,’ Mary tells us. ‘And then because the hormone dose in the combined pill was so much greater than today, my periods took many months to return, and I was investigated for possible infertility.’
‘This high dose is now known to be a risk factor for later breast cancer,’ she adds. ‘Coils were not offered to women who had not had children, so the alternatives to the combined pill were not reliable enough.’
Clue’s Sarah feels that it’s high time men had their own hormonal option, to help shoulder the burden of the potential side effects.
According to research from 2019, a third of sexually active British men said they’d consider taking hormonal contraception if it was readily available, while it was reported earlier this year that a contraceptive pill for men may be on the horizon after one study found it was successful on mice.
‘Findings suggests that men will be willing to take birth control to prevent pregnancy,’ Sarah says. ‘But the side effects of hormones are deemed “unacceptable” for men.
‘Women and people with cycles have long dealt with the side effects of the pill, but perhaps that’s because we better understand the consequences of pregnancy and its side effects.’
In a similar vein, Alice says we need ‘innovation’, adding: ‘While there have been various changes to the ways these hormones get into our bodies (injections, patches, implants, coils) scientific trials show there are hundreds of ways we can prevent pregnancy in male and female bodies.
‘We need pharma companies to care about this drug category again – currently, they only funnel 2% of their annual revenue from contraceptives back into research and development.’
Simon Nicholson, managing director of women’s health company Organon, believes that the future of contraception also needs to be about sex education and the pill being more readily available around the world and in different socio-economic groups.
‘Unfortunately, the reality is that even in this day and age, not everyone has access to it,’ he explains. ‘Unplanned pregnancies are still a big public health issue.
‘From 2015-2019 there have been in excess of 121 million unintended pregnancies (UIPs) each year around the world. Furthermore, according to a 2019 study, 218 million women (aged 15-49) in low-and-middle-income countries still don’t have access to contraception.’
‘In the UK specifically,’ he adds, ‘with initiatives like the Government’s Women’s Health Strategy [which aims to ‘set out an ambitious and positive new agenda on women’s health’] there is an opportunity to reach out and connect with segments of society that aren’t getting the care they deserve.
‘It’s hard to believe, but we know that there are still inequalities in the UK within certain socio-demographic groups, who have challenges because of the postcode they happened to be born or live in. So the future, without question, has to be focused on changing that.’
While there’s room for improvement and innovation – with research being done with a view to hopefully developing a hormonal option for men – Simon says, ultimately, the ability to control when one becomes pregnant has ‘empowered millions of women around the world’.
‘It’s hard to quantify,’ he explains. ‘But I’d definitely put the pill up there with great public health interventions that have had a worldwide impact. It’s just as vital to us now as the availability of clean drinking water, sanitation, and vaccines.’
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