The use of contraceptives raises debates and raises questions related to women’s health. Used for hormonal issues, fertility management or specific health issues, the pill was a groundbreaking item launched in the 1960s but is now under pressure to be pushed aside by women. But, after all, is it safe to use the medicine? Doctors from Santa Catarina explain the matter.
Before ruling on the use of the method, it is worth understanding in which cases it should be used. Despite being the most used contraceptive by Brazilian women, around 58% – according to a 2021 survey published by the Ipsos Institute, one of the largest research companies in the world – it can, in some cases, be replaced by natural options.
“Many people seek contraceptives as a contraceptive and to treat health issues due to lack of adequate information from their health professionals. There are ways to take care of yourself that are related to lifestyle and financial conditions. It is possible to take care of some [tratamentos] herbal medicines. For example, menstrual cramps can be addressed with lifestyle and physical therapy”, reveals gynecologist Halana Faria.
There are no figures that show the number of pill users in Santa Catarina, but, according to the published survey, other contraceptives, such as the so-called condom, appear in second place, with 43% of the 450 Brazilians heard from all regions.
Only 13% of women said they did not use any product for contraceptive purposes, claiming to master reproductive planning. The copper IUD came in third at 8% and the monthly injection was last at 6%.
Bunch of options
“Hormonal methods must be part of a range of options in relation to contraception, but, hegemonic and historically, it is used as if it were the only option. People resent, nowadays, for going to doctor’s offices and receiving hormonal methods as the only option”, concludes Faria.
As if the lack of information wasn’t a problem in itself, the doctor explains that the behavior can affect other situations. “Many of the health issues, whether polycystic ovary syndrome or endometriosis, are not addressed more fully, and hormonal methods are prescribed, not necessarily for contraception, but for health care.”
“The pill can also be indicated for some situations of polycystic ovary syndrome, to reduce excessive bleeding, but not as a treatment, as it is a metabolic syndrome. The pill can even make this metabolic syndrome worse, so you need to guide people to really solve this problem.”
The gynecologist reinforces that there can be benefits, yes, in the use of the pill, but it is worth keeping an eye on the effects and consequences of a use without medical supervision.
“Yes, there may be improvement in the skin, in some symptoms of excessive bleeding, menstrual cramps, but we also have to think about the questions that talk about an association between pill use and increased chances of breast cancer, antidepressant use in young people… there is an increase in liver disease, diabetes and cervical cancer. Whenever we prescribe the pill, we need to take into account possible side effects.”
On the opposite way
However, it is not necessary to ‘blame’ the use of the contraceptive pill. With several formats available to be used, the tablet is offered uninterruptedly or interspersed, with a break of a few days for menstruation.
“For each patient, the best way to take [o remédio]. Its action not only inhibits ovulation, but also alters cervical mucus and tube mobility”, says gynecologist Ana Rosa.
It can still serve as an agent in combating pain caused by the menstrual cycle. “It can improve PMS symptoms, breast pain, irritability, or endometriosis symptoms, anemia due to blood loss, it also helps in cases of ovarian cyst, and reduces ovarian, endometrial and intestinal cancer”, he points out.
However, the indication to ingest the pills needs to go through an evaluation of the history of each patient, as Rosa explains. “You need to know if you have had thrombosis or pulmonary embolism, history of thrombophilia, if you will have surgery, if you have lupus, if you are a smoker, obese, age… there are several considerations to evaluate before recommending use”.
Among the reports of side effects, some are more common in offices. “Some patients report mood swings and weight gain when using birth control. Regarding mood changes, there is a data that states that one in every thousand women needs to use antidepressants. Fluid retention is temporary, the body tends to return to normal weight.”
“Another very common complaint is the drop in libido. Therefore, many women are stopping the hormonal method and looking more at the body. Some women who just used the pill as soon as they started menstruating don’t even know their cycle. Currently, there is a tendency to discontinue use, to get to know the body”, says the doctor.
Historically linked to the woman, the responsibility for a pregnancy begins, in current times, to gain new protagonists. After the emergence of research and prototypes of male pills, women take the opportunity to understand that the use of contraceptives, although effective in combating unwanted pregnancies, may not be just their responsibilities.
According to a study carried out by a team of scientists, led by Abdullah Al Noman and Gunda Georg, in the United States, the male contraceptive was 99% effective in tests carried out on rodents and, now, the drug will undergo tests in humans, and may reach to the market in less than five years, according to information from the UOL Portal.
Regarding the use of feminine medicines, the social contours still weigh. “There is enormous inequality in terms of reproduction. We need to bring this debate to a head. In the office, I see women who have already given birth, are in stable relationships and they are still the ones who need to worry about whether they are going to have an IUD, whether they will have a tubal ligation or will start using a hormonal method”, ponders Halana.
Finally, she issues a warning. “The pill, after the age of 40, needs to be very well thought out, because there is an increase in cardiovascular risk, but [as mulheres] nor do they consider that partners might consider a vasectomy.”