If you watched the recent documentary, Davina McCall's Pill Revolution, you'll likely have had contraception on your mind. Even if you didn't, it would have been hard to ignore McCall's findings, which made headlines for days - but what was presented as shocking new information by news outlets felt like common knowledge for most women. Violent mood swings brought on by the Pill, loss of libido, weight gain and wait times for prescriptions and care getting progressively longer are, for many of us, just something we're told to 'put up with'.
The Pill remains by far the most popular method of contraception in the UK, with an estimated 3.1 million women currently taking it. Of course, other methods are available, including contraceptive implants and IUDs (often called 'coils'), but the Pill, either combined or progestogen-only, is what's most commonly offered. When I started hormonal contraception aged 19, my doctor never told me there was another option; I have been on the combined pill ever since. Thankfully, I've experienced few side effects - but the same can't be said for everyone. Research says that 85 per cent of women admit hormonal contraception has harmed their romantic relationships, and experience side effects like mood swings, anxiety, mental or emotional exhaustion, and a loss of sex drive, almost daily.
The Pill was developed during the 1950s by American scientists, with the support of women's rights campaigner, Margaret Sanger. When it was released in 1960, take-up was swift: within two years, it was being used by 1.2 million American women. The Pill was heralded as an emblem of free love and women's liberation; these days, when women are offered so little agency over their own bodies and so few other options, it feels like it represents the exact opposite. The Pill was supposed to be egalitarian, but in reality, much of the contraceptive care we receive in the UK is based on privilege, with GPs in the richest areas and those with the lowest ethnic minority populations spending the most on birth control. What the Pill was meant to stand for is, arguably, being erased.
"When it comes to contraception, the options for women haven't really moved on since the 1950s," says Dr Bryony Henderson, lead GP at digital heath company Livi. "There has been a boom in 'femtech' in recent years, but these products often rely on existing contraceptive methods such as the rhythm method. There is a distinct lack of funding for female health research, so innovation and our understanding has failed."
And it's not just contraception - anyone with a womb will recognise the trials and tribulations of female health care across the board which, from miscarriage to menopause, is woefully misunderstood and underserved in the UK. Caroline Nokes, a Conservative MP who chairs the Women and Equalities Committee, previously confirmed this to Bazaar, explaining that "medical trials often exclude women, there is less research into gynaecology than other areas, and health conditions like strokes and heart attacks are frequently overlooked". For example, only four per cent of the UK's cardiac-disease research budget is focused on women, even though they are more likely to die of a heart-related problem than men.
Gynaecological concerns particularly tend to get "pushed to the back of the queue", adds Nokes, partly because they are still perceived as embarrassing. "There are many challenges, not least the fact that on social media it is OK to talk about erectile dysfunction, as it is considered a health issue, whereas vaginal dryness is deemed to be pornographic - that's just a snapshot of the rules determined by men, for men."
So what can be done to close the gender health gap? When it comes to contraception, according to Henderson, women should feel comfortable asking for better care - and arming yourself with knowledge is a good place to start. "It's essential that women are given tailored advice and treatment that takes into account their health, bodies and wishes, rather than a generic contraceptive plan," she says. "Education will help empower women to seek the help and advice that they deserve. Our dedicated content hubs offer advice on a range of female health issues to ensure that a woman of any age can get access to advice and guidance she needs."
Much more needs to change, however, in order for women to be given the standard of care they deserve. "We do need better research and education on women's health issues," says Henderson. "It's great that these are key pillars of the government's Women's Health Strategy but at the moment we are seeing female health issues being treated in isolation. We need to turn these ambitions into action, with support for more female health training for healthcare professionals and recruitment of female health specialists."
The first step towards change is often awareness, and McCall's documentary has brought the conversation around hormonal contraception into the limelight. If enough of us continue to question the care we are given, demand better options and speak out about the issue of substandard contraception, we may just be able to move the dial - and make sure no woman has to just 'put up with' inadequate care ever again.