A gesture that was somewhat liberating in its day – taking a tablet of contraceptive pills out of the bag and proceeding to take the one that touches –, and later became something daily and assimilated, has begun to have something controversial. Today, if that is done among young women, it is highly probable that those present form a chorus of concerns: that is poison. What are you putting into your body? They will give you thrombi. Your sexual desire will disappear. Anxiety will skyrocket. you will get fat You’ll get hair everywhere. Have you consulted with another gynecologist?
It has ever happened to María Domínguez, 22 years old. “I have been using the pill for three years, because I am in a stable relationship and it seemed like the safest option. When I started taking it she was younger and many girls around me were taking it too. It is true that as I continued using it, I have been left alone. We are very few, also because we are few with stable relationships. Sometimes I talk about it with friends and it is true that they give me the sheet with the adverse effects, I think that sometimes from ignorance ”. Although it has worked well for her to regulate the menstrual cycle and even to eliminate acne, it is also true that it causes her “anguish” to think that she will spend many years of her life taking hormones.
The biannual surveys published by the Spanish Contraception Society (SEC) timidly begin to reflect this rejection of younger women to hormonal methods (the pill, the vaginal ring and the hormonal implant, in addition to IUDs that contain hormones). The pill continues to be the second most widely used method, after the condom, in all age groups and reaches its highest use among women between 25 and 29 years of age. However, in the bracket from 15 to 19, 27.6% of the women who responded to the survey in 2020 have gone from taking it to 19.4%. Among girls between the ages of 20 and 25, only two years ago 30% took it and now the incidence has dropped five points. It is 25% who use it.
“It is true that we notice that younger people have demonized the use of hormones. There is a wave of information also through influencers and on Tik Tok in which that very negative image is given”, points out Isabel Silva Reus, a gynecologist in Villena (Alicante) and vice president of the SEC. “Hormonal contraceptives can help heavy bleeding, prevent anemia and ovarian and endometrial cancer, but that is said very little,” she defends.
Silva also points out that the bad reputation of hormonal methods has been dragging on since the first generation of pills. “Those that are sold in pharmacies today have a quarter or fifth of hormones” and points out that, in any case, they must be prescribed after having done blood tests, taking blood pressure and calculating the body mass index, something that is not It is always done in gynecological consultations.
The so-called natural methods of contraception have been gaining popularity for some years now. They are promoted by some influencers, who recommend using applications such as Natural Cycles. The problem, Silva points out, is that for these methods to work you need to have a supreme knowledge of your own body and have been monitoring the cycles and changes in body temperature regularly since puberty.
In January, the academic journal Health Communication published a report prepared by scientists from the University of Delaware in which they analyzed videos from 50 YouTubers with a minimum of 20,000 followers each. They all advocated stopping hormonal contraceptives and trying, for example, the cycle control method, for which you have to take your temperature every day at the same time and control the viscosity of vaginal mucus. Or use ovulation predictor kits, which measure the amount of certain hormones in your urine to determine when you are fertile. The study described these methods as “potentially harmful” since it is difficult to maintain a regularity in the control and isolate all the variants that can, for example, alter the basal body temperature.
Back in 2018, one of the largest hospitals in Stockholm noted that 37 out of 668 women who had miscarried in the second trimester had gotten pregnant using (mis) the Natural Cycles app, and the Swedish medical authorities issued an advisory warning about the dangers of these methods. In the United States, it is a spermicidal gel called Phexxxi that has set off alarm bells. Marketed since 2020 and marketed with an aggressive and award-winning campaign that made a lot of impact on Tik Tok, Phexxxi is a spermicide designed to be used alone – not like the gels of this type that are sold in Spain, indicated to be used as a complement to a diaphragm. . The idea is that an acid barrier is created in the vagina that prevents sperm from reaching the eggs. It’s actually made mostly of lactic acid and citric acid, and as one doctor noted in a recent Rolling Stone article, “it’s like putting lemon drops in your vagina and hoping you won’t get pregnant.” The report, in fact, collects many cases of women who have conceived using Phexxxi and, given the restrictions on abortion in much of the United States since the Roe vs. Wade law was repealed, they have encountered serious problems.
“Welcome to my vagina,” said Schitt’s Creek actress Annie Murphy in the most famous advertisement for Phexxxi gel. Sitting on a pink sofa, in an entirely pink room, she continued: “Here I make the rules. Rule number one: no hormones.” The founder of the company that markets it, EvoFem Biosciences, also always emphasizes that message in the same article: “we don’t want hormones in the milk we drink or the meat we eat, and we wanted a product for women who want the empowerment to use something on demand.”
Like many women of her generation, Lucía Noal, 22, has consumed messages of this type, especially through Tik Tok. “I see videos of these North Americans saying that they take their temperature and use apps to track their cycle, but it takes me back a lot. I haven’t seen any doctor say that’s reliable,” she says. Her history with contraception is quite common. She was recommended the contraceptive pill for the first time when she was barely 15 years old to alleviate her painful periods. “But she didn’t want to take it because she thought she was too young to medicate me and because even then what we women believe was very well integrated, that you have to suffer your period.” Finally, she was prescribed it, without prior analysis, at 17 and she took it for a year and a half. She cured his acne but caused him “a huge emotional imbalance.” “She multiplied my anxiety by 25, she gained 25 kilos, many things happened to me that no one had explained to me.” After stopping taking it and making a pilgrimage to five gynecologists, she requested a more exhaustive analysis of her case and tried, already at the age of 20, another brand of birth control pill that works better for her. “I am surprised that at this point in the film everything remains the same. I would like a more holistic, more integrative approach, not a: take this and that’s it, ”she denounces.
This type of reluctance represents “a sector that has more sensitivity and an egalitarian and feminist vision” of the menstrual cycle and sexual relations, but not yet the majority, believes Lara Herrero, a sexologist with the Dialogasex association. In her day-to-day life, Herrero gives educational workshops to a huge range of the population, from preschool children to the elderly, and what is basically found is retrograde attitudes when it comes to contraception. “In the talks in the institutes, we noticed that hormonal methods remain among very young girls and that when we give information it is these methods that arouse their interest. This responds to the fact that they do not want to use a condom and they do not have the skills and tools to know about the consequences. When we want to talk about co-responsibility in heterosexual coital relationships, we find that men do not assume that responsibility, only they do”. In the association they observe that the pills are “overprescribed” among adolescents, who often make “unhealthy use.”
“They want to access these methods without having health guidelines, without having an analysis done, without being aware of the menstrual cycle. Many times they don’t even distinguish between the emergency pill and the contraceptive pill”. In addition, trusting everything in the pill without practicing the “double method” (always add a condom) that the SEC always advises leaves the field open to genitally transmitted diseases. In this regard, however, Herrero is emphatic and asks “not to demonize” younger people, since she sees deficiencies and unnecessary risks every day in all age groups, for example in women who reach menopause leave to use any method. Probably after decades of hormone intake.