Margot* always felt confident taking her contraceptive pill. “I never experienced any side effects aside from getting slightly larger breasts, which I thought was great,” she says. “I took it religiously for four years and everything was going great until my GP told me they could no longer offer me that same pill because it had run out.”
Instead the 26-year-old from London was offered a cheaper alternative that she was promised contained the same ingredients, just with different branding. “It made me so unwell,” she recalls. “Suddenly I was experiencing constant nausea in the mornings, vomiting and I had the mother of all periods.” Thankfully, Margot was eventually able to get hold of her old pill through private healthcare provided by her employer. “If I didn’t have that, I’d be screwed.”
Margot is just one of the women across the UK who has suffered the consequences of contraceptive shortages, which health officials have warned is causing “chaos”. It’s not clear why the shortages are happening, but without access to their regular contraception, women around the country are being forced to find alternatives that require major expenses, lifestyle changes or leave them with a whole host of uncomfortable side effects.
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On Friday, the Royal College of Obstetricians and Gynaecologists (RCOG), the British Menopause Society and The Faculty of Sexual and Reproductive Healthcare (FSRH) wrote to the secretary of state for health and social care, Matt Hancock, urging for a working group to be set up to address ongoing supply constraints for both contraceptives and hormone replacement therapy in the UK. As well as this affecting the physical and mental wellbeing of women and girls, the professional bodies are concerned that contraceptive shortages will affect the most vulnerable in society. The RCOG has also said shortages could lead to a rise in unplanned pregnancies and abortions.
Speaking to The Independent, Julia Hogan of Marie Stopes – one of the UK’s leading abortion providers – explains that they regularly speak to women who have experienced difficulties accessing contraception. “Not only have many services been shut down due to cuts to sexual health clinics, but when women do manage to find a clinic many are being denied the full range of contraception, including some of the most effective long-acting methods,” she says.
Such restrictions, Hogan says, put limits on women’s bodily autonomy and leave them with fewer choices. “It’s enormously concerning and frustrating,” she adds, “because investment in contraceptive care is one of the most cost-effective public health measures, with every £1 invested in contraception saving £11 in averted costs.”
One form of contraceptive that has been impacted is Sayana Press, a self-injectable contraceptive for which there is no exact alternative. “Women who use Sayana Press now have to see a healthcare professional to access a non-self-injectable alternative, which is undoubtedly an extra burden for them, increasing demand in busy GP practices and sexual and reproductive healthcare clinics,” said Dr Asha Kasliwal, president of the FSRH. “At the moment, the resupply date for Sayana Press is unknown.”
Paige, 26, had been on Sayana Press for 11 months and found it an accessible and easy to manage form of contraception. But when she recently went to her GP for a top-up, she was told they had run out and was promptly sent around to walk-in clinics, pharmacies and other doctors to no avail. “The whole experience left me feeling anxious and stressed,” Paige says, explaining that she regularly had to leave work early to make calls to clinics or attend doctor appointments.
“I felt as though my right to access my chosen contraception was being taken away from me and I didn’t want to drastically change my contraceptive during a time when I was already moving house and going on holiday.” While on her hunt for Sayana Press, Paige, who is based in London, visited one walk-in clinic, called two, attended one GP appointment, one appointment with a nurse and visited three different pharmacies.
“Not one of these informed me that there was a shortage of Sayana Press in the UK.” It was only through her own research that she discovered Sayana Press had been recalled due to a manufacturing fault, which had resulted in the shortage. “Ultimately, I had to change my contraception and am now using Depo-Provera, which I’ve been on for four weeks so far.”
Paige said the changeover has been fairly straightforward, although she can no longer administer the injections herself at home and must visit a nurse every 12 to 13 weeks to receive it. “I liked using Sayana Press because it removed the issue of trying to book an appointment so often with the nurse,” she says. “Securing appointments is getting harder and harder and when you do, managing to get one out of work hours is nearly impossible.”
Funding for sexual health services has plummeted in the last eight years after sexual health clinics were made the responsibility of local councils, rather than NHS England in 2013. This meant that funding clinics receive is part of the same pool that also pays for bin collections and speed bumps. The change has seen a reported £64m less being spent on sexual health services, according to the British Association for Sexual Health and HIV. With less funding, clinics around the UK are closing while others have started turning patients away. These contraceptive shortages mean there is additional strain being put on an already stretched service.
Alex*, 42, also had a negative experience when the pill she’d been taking for years was suddenly discontinued. “I liked it because I had very slight monthly bleeds and it gave me no side effects,” she explains. “Suddenly it just stopped being manufactured, and my GP could give me no explanation as to why. Instead, my doctor prescribed me another pill that was the wrong dose and severely affected my mental health.
“I just had a tough time emotionally, and it was hard to know if it was just life load or it was because the levels of oestrogen in my body were wrong”. Now, Alex has started using a different pill that seems to be “okay” so far, though it gives her headaches. “I’ll try it for a couple of months to see if it settles and just take paracetamol in the meantime.”
Alex says the impact is undoubtedly gendered and creates an unfair burden on women. “It’s just yet another responsibility that falls to me as a woman,” she says. “It’s up to me to go to three chemists in my lunch hour to see if they’ve got it in. It’s up to me to go back to the doctor and ask for a new script. It’s up to me to collect it, try it, feel ill, go back, try another one. But ultimately I’ve just had to get on with it.”
Molly*, from south east England, suffers from an autoimmune disease, which means she’s not medically allowed to use any of the hormonal contraceptives. “I can only use the copper coil,” she explains.”It took months just to get an initial consultation appointment at my local sexual health clinic. Then I had to book another appointment after that before I could even book my coil fitting. I called seven different clinics looking for someone who could sort me out sooner.”
Molly now has to wait four months for her copper coil to be fitted; the waiting time is making her anxious. “I’m just trying to be a responsible adult,” she says, explaining that she’s just started seeing a new romantic partner. “I feel like I’m gambling every time I have sex. It’s not fair and is making me feel really uneasy, which I shouldn’t have to feel in a new relationship when everything’s meant to be so fun and natural.”
*Some names have been changed to protect identity