World Contraception Day - 26 September 2023
Written by Megan Fuller, VP Founder Engagement & Operations, FemHealth Insights
World Contraception Day takes place every year on September 26th, with the mission to improve awareness of all contraceptive methods available and enable people to make informed choices about their sexual and reproductive health. The development of the hormonal contraceptive pill was arguably one of the biggest steps ever made for women’s autonomy, rights, and lives. But there still exist many barriers and challenges around access and use of contraceptives today.
Access
Non-profit advocacy group, Power to Decide, estimates that almost 20 million women in the US live in contraceptive deserts - counties where the number of health centers offering comprehensive reproductive care does not meet the needs of the county’s residents. And 1.2 million of these women are in counties without a single health center. Luckily, companies such as Nurx and Pandia Health, are working to change this by offering reproductive care via telehealth - providing online prescription and offering home delivery of some contraceptive methods.
Another company, Adyn, has this year partnered with Power to Decide - to bring attention and urgency to the contraceptive crisis across the US. For every submission of their 2-question contraception survey, Adyn will donate $10 to Power to Decide’s Contraceptive Equity Initiative, which aims to expand research and policy efforts to support contraceptive access.
Side Effects
It’s impossible to talk about contraception without discussing side-effects. The Lowdown (“tripadvisor for your vagina”), allows women to rate their contraceptives and list any side effects. A quick scan of the reviews highlights hormonal side effects such as breakthrough bleeding, fatigue, acne and anxiety. Unfortunately, despite these physical and mental health drawbacks, there has been very little innovation or progress in hormonal contraceptives. The IUS for example, uses the same hormones as the progestogen-only pill, and as the implant - a small rod placed under the skin on your arm, releasing progestogen into your bloodstream for up to 3 years. Similarly, the vaginal ring, combined pill and patch also all use the same hormone combinations. We’ve had 42 models of the iPhone since 2007, but we’re still using the same contraceptive methods as we did in the 1960s. It’s no wonder women are frustrated!
So what’s being done about it? We are excited to see that there are companies looking to create alternatives. Arstat Pharmaceuticals is creating contraceptives for overweight and obese women, and Cirqle is developing technology that would provide a non-hormonal, localized option - but unfortunately, these products are still very early stage and will not be available for some time.
Lack of Education
So many issues in women’s health could be solved or improved if we simply taught women how their bodies work. Flo Health reported that in the US, 45% of women (63% if aged 18-24) believed they had ‘learned’ more about women’s health from social media than in school. In-school education is limited on this topic and so it’s hardly surprising that women learn most about contraception through self-research. But again according to Flo, 18% of UK women don’t do any research at all when deciding on a form of contraception, meaning that they may not be using the best method for them, or they may even be using it incorrectly.
Similarly, fertility awareness methods (FAM) would be much easier to understand & implement if we were taught the basics of the menstrual cycle in relation to reproduction - Flo Health’s US report also highlighted that 54% of women did not know how many days per month they are fertile. If women don’t understand how their bodies work and what FAM is tracking they will continue to underestimate the importance of adherence to the program and FAM will continue to be unfairly judged. We must ensure women are given the necessary and correct information in advance, so that they can make an informed decision for themselves.
Thankfully, there are some fantastic resources out there providing factual and accurate information about contraception. Clue, The Lowdown, and Reya Health all provide excellent content that cuts through the misinformation - dispelling myths and providing correct, scientifically backed information to consumers.
Not teaching women about our own bodies also means that we can be easily misinformed or misled by the content we consume. Compounding the problem, we are also seeing voices censored when they do share information or try to educate women.
Medical Misinformation
Women are talking about their contraceptive experiences more than ever before, and in the age of social media, this conversation is only amplified. Getting our health information on social media does cause its own problems though, as the BBC recently highlighted with this video discussing the risk of using social media as a source of medical information. It’s easy to see how it happens - #medicaltiktok has over 7 billion views on tiktok. FemHealth Insights founder, Dr. Brittany Barreto, recently uploaded a product demo that amassed more than 2 million views in 48 hours. People are turning to social media for their medical information for a number of reasons - including inability to access a medical professional, speed of answers, or because they find the content relatable. And according to Flo Health’s UK report, 72% never double check the health information they get on social media. The problem is that without verifying each and every video that’s posted, medical misinformation is inevitable. But what we can do is make sure that medically correct content is being shared, particularly via influencers. Accounts such as The OBGYN Mum, Talks with Dr Sesay and Dr. Temeka Zore are great examples of medical content that is both accurate, and relatable.
Media Censorship
At the end of the BBC video, it states that TikTok say they removed videos that “violated rules on medical misinformation”. Of course, some videos are exactly that. But others - like the one of a woman using her pill side effects leaflet as a blanket - sadly are not, and as a result many of the viewers are, understandably, frustrated. Because in not being clear about what’s accurate and what’s not, the video appears to label women sharing their experiences, as misinformation. This probably wasn’t the intention, but in 2023, it’s frustrating to see this dismissal of women’s views.
Lack of Options
The key with contraception is knowing what your options are, and as we talk more openly about our experiences with hormonal contraceptives, many women are looking to non-hormonal alternatives. There are technically a number of options here, but they’re not widely available - your options are generally the copper coil (IUD) or fertility awareness methods (FAM) but these methods come with their own side effects and challenges.
How Can We Improve?
There are lots of things we can do as women’s health advocates, and as human beings, to improve the world of contraception.
Talk about the positives. If a contraceptive is working perfectly, you’ll barely give it a thought, so if you are noticing something, it’s probably not a good thing. That’s why we’re quick to complain about side-effects. But hormonal contraceptives can make periods lighter, or stop them entirely. Some pills are reported to improve skin, or increase sex drive, and this is reflected in the many positive reviews on The Lowdown’s site. The benefits of non-hormonal options are that you don’t have to worry about hormonal side effects, and can get to know your body better. And crucially, contraception prevents pregnancy. We undoubtedly need more and better options, but it’s important that we don’t forget the important benefits these tools bring women today.
Improve education. Navigating the world of contraception as a consumer is already a minefield. Ultimately, it’s vital we provide women and girls with facts, so that they can make an informed decision for themselves - whether that’s a decision made now, or later in life. That also means bringing the content to them. According to a survey by CharityRx, almost 1 in 5 Americans will consult TikTok before their doctor for health advice, with a similar proportion saying they trust health influencers more than medical professionals. This means we need to be creating accurate content on social platforms ourselves, and working with health influencers to reduce misinformation. Social media is a powerful tool that can and should be used to our advantage.
Research. Finally, we need to collect the data, and use it. Both to improve the methods we’ve got, and to create new methods that serve us better. There are companies working on this, but their technologies are best-case in clinical trials - most are yet to even reach that stage. We need funding into R&D to get new solutions to market that are scientifically backed and trusted by healthcare professionals.
Ultimately, knowledge is power and the more knowledge we can produce and share about contraception, the more everyone will benefit. For FemHealth Insights this means supporting and promoting those companies doing the research, developing the solutions, and providing the access. By doing our bit, we hope that one day every person will have easy access to a contraceptive that works well for them.
About the Author:
Megan Fuller is VP of Founder Engagement and Operations at FemHealth Insights, where she is responsible for community management, events, and marketing. She is also Producer of the FemTech Focus Podcast.
