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Period pain can feel like one of those things you can't avoid, especially if you don't want to take the pill.

My approach has always been to give thanks to the inventor of ibuprofen and get on with things, grateful to dodge the pill and zap my pain.
But it is pretty rough that all modern science can offer women (through the NHS website) is the advice that period pain is a “a common and normal part of your menstrual cycle.

So when Lara Briden came along with the revolutionary idea that periods are not meant to be painful, I was intrigued and bought her book – the Period Repair Manual.

I was sceptical because Lara is a naturopath and some terrible people claim to be naturopaths. People who suggest green tea supplements that ruin livers, or claim they can cure cancer with alkaline injections.

Lara does not seem like a terrible person, but she does recommend lots of supplements, and these can mess  with our prescribed medication, and our general health - as well as being expensive.

But mainstream medicine isn’t risk-free either – especially for women. Thousands are currently going through hell thanks to the medically approved vaginal mesh.

And regulators are failing to protect us from all sorts of harmful products – watch the Bleeding Edge documentary on Netflix if you need convincing, or read Bad Pharma.

So I was both wary of Lara’s book and not completely resistant to trying something a bit different.

Yes the pill has its place, but putting your cycle to sleep is an extreme fix for period pain.

It can also mask health issues that you might be able to uncover - and fix - if you allow your body to do its own thing.

I like the idea of avoiding period pain rather than treating it - preferably in as undramatic and low-risk a way as possible.

The foundation of her book is certainly undramatic - it's all those sensible lifestyle things that we know we should do but might struggle with.

You know the drill. Don’t smoke. Avoid too much alcohol, sugar and gluten. Eat proper meals and good fats. Exercise in a way you enjoy. Sleep enough. Look after your mental health.

She goes slightly further than standard public health advice because she recommends an anti-inflammatory diet and lifestyle. That means taking things up a notch and avoiding gluten and the wrong kind of dairy, among other things.

Lara's tone is encouraging. She says “honour your hunger” and “honour your emotions” - and she is realistic, it's not as if you can never eat another slice of bread or bowl of pasta.

And I like her focus on your period as way to judge your overall health - your “monthly report card” - rather than simply an inconvenience.

So, apart from all the lifestyle stuff, what does Lara suggest for period pain - and other period problems like acne, PMS, PCOS, endometriosis, fibroids and the the rest?

I'm simplifying - Lara covers lots of treatments, including surgery - but she makes a strong case for taking magnesium.

The NHS website says you should be able to get all the magnesium you need from food but it also says a supplement of less than 400mg a day is unlikely to cause harm, and PubMed has a promising review article.

So I followed her advice. I bought some tablets from 375mg tablets from Boots, took one a day (in the evening after food) - and (sound those trumpets) my period pain disappeared!

Revolutionary stuff. Except, there was a snag. I got stomach problems.

As the NHS website warns, magnesium is a laxative, which was not the kind of revolution I was looking for.

So I stopped taking it, and my stomach improved but the period pain came back.

I tried a more expensive kind of magnesium, which is meant to be gentler on the stomach, but the problems continued, so I simply kept my dose low, about one 375mg tablet every 3 or 4 days and the pain stayed away.

Overall, I think that that is a pretty good result - and the spotting before my period disappeared, which is very handy if you are using the 3 over 6 rule to avoid pregnancy.

I can't claim that magnesium will fix your period pain, but I do think it is worth a try - just keep your dose low and check with a pharmacist that there no interactions if you are on any medication.

And if things are very bad please see your doctor - get a new one if they are unsympathetic.

That review article shows there are doctors who are interested taking a more low-key, and evidence-based, approach to period problems than the pill.

I am encouraged by this because we need people to fix women's pain, not simply accept it as "normal", and I think Lara Briden might be part of the solution. You can buy her book here. 

Other revolutionaries
I also find feminism therapeutic. These are among my favourite books: ___
Affiliate links - the Amazon links for those books mean I receive a (very) small payment if you buy one. You don't pay anything extra.
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Much as I love the NHS website, it is disappointing that it describes period pain as “a common and normal part of your menstrual cycle.

All it really suggests is painkillers and patience, or seeing a doctor if things are really bad – a doctor who will probably suggest the pill.

The pill has its place, but putting our menstrual cycle to sleep does seem like an extreme option.

Surely we can do better than that?
So when Lara Briden came along with the revolutionary idea that periods are not meant to be painful, I was intrigued and bought her book – the Period Repair Manual.

I was nervous because Lara is a naturopath and some terrible people say they are naturopaths. People who suggest green tea supplements that ruin livers, or claim they can cure cancer with alkaline injections.

And we've all heard how even apparently harmless supplements and vitamins can mess with our prescribed medication, and our general health - as well as being expensive.

But mainstream medicine isn’t risk-free either – especially for women. Thousands are currently going through hell thanks to the medically approved vaginal mesh.

And regulators are failing to protect us from all sorts of harmful products – watch the Bleeding Edge documentary on Netflix if you need convincing, or read Bad Pharma.

So I was both wary of Lara’s book and not completely resistant to trying something a bit different.

Ibuprofen has always worked for me, but I liked the idea of avoiding period pain rather than treating it - preferably in as undramatic and low-risk a way as possible.

The foundation of her book is certainly undramatic - it's all those sensible things that we know we should do but might struggle to always get round to.

You know the drill. Don’t smoke. Avoid too much alcohol, sugar and gluten. Eat proper meals. Exercise in a way you enjoy. Sleep enough. Look after your mental health.

She is encouraging - “honour your hunger”, “honour your emotions” - and not too strict, you can still eat some bread and pasta.

I like her focus on your period as way to judge your overall health - your “monthly report card” - rather than something that has to be put to sleep with the pill.

She recommends lots of supplements, which makes me uneasy - and the Daysy fertility monitor, which I'm not a fan of either -  but her case for magnesium for period pain is strong. And frankly it's your body.

The NHS website says you should be able to get all you need from food but a supplement of less than 400mg a day is unlikely to cause harm, and PubMed has a promising review article.

So I followed her advice – bought some tablets from 375mg tablets from Boots - and my period pain disappeared!

Revolutionary stuff. Except, there was a snag.

As the NHS website warns, magnesium is a laxative, which was not the kind of revolution I was looking for.

So I stopped taking it, and my stomach improved but the period pain came back.

I tried a different kind of magnesium which is meant to be gentler on the stomach, but it wasn’t any better – and cost more – so I simply kept my dose low, about one 375mg tablet every 3 or 4 days and the pain stayed away.

So I really don't know if magnesium is a brilliant cure, but I do think it could be worth a go - just keep your dose low and if you are on any medication, check that there no interactions – speak to a pharmacist.

Let me know how you get on if you decide go ahead, or if you have already tried it, or if you prefer to stick with painkillers and patience or the pill.

All I can really say is it's about time we had a fix for period problems and I think Lara Briden might be part of the solution. She might even be the period revolutionary, just like it says on her website.
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I was nervous about this programme. A doctor, on the BBC, talking about pill safety - it’s bound to dismiss women’s concerns, isn’t it?

So I was pleasantly surprised when there was no lecture telling all women they should really
use a long acting method like the implant, ring, injection or coil.

Maybe this was because a woman presented the programme – Dr Zoe Williams.

She simply said most women prefer the pill to long acting methods and skipped the lecture.

I was also pleased the mental health problems associated with the pill were not dismissed.

The programme quoted the official statement that this is an association rather than a causal link, AND they took concerns seriously. Brilliant stuff.

As well as the Danish study (hurrah for massive data sets), I think this was thanks to the journalist Vicky Spratt - who was part of the programme - and to Holly Grigg-Spall for her “pillsplaining” article and her book Sweetening the Pill.

Libido concerns were also taken seriously. They interviewed women about their experiences and had a sympathetic researcher – Dr Cynthia Graham - talking to them about the impact of the pill.

Cancer is where things got more complicated.

For pill users, there is a small increase in breast cancer risk. At the same time, the pill protects against less common cancers. Overall the lifetime risk of cancer is the same for pill users and non-users, which is reassuring.

However, I felt uncomfortable when they discussed these statistics with a young woman who had lost her mother to breast cancer, asking her “what do you think now?” after telling her all the stats. That did not feel appropriate.

But my biggest disappointment was the way the programme discussed the risk of blood clots – something which concerned 48% of women in their survey.

It would have been wonderful if they could have continued with the approach used for mental health and libido and listened to women who had experienced blood clots. I would have welcomed that alongside a calm and clear explanation of the stats and what symptoms to look out for.

Instead we heard from a clinician who talked about the alarming increase in the abortion and unplanned pregnancy rates after the 1995 pill scare, and from another who treats blood clots and mainly sees pregnant women.

The message was simple. Don’t panic, there's a small increase in risk but it’s better than the alternatives - which are abortion and unplanned pregnancy. As if non-hormonal contraception doesn’t exist.

I was not surprised that the programme assumed all women want to avoid periods – many clinicians seem to think this.

One woman I spoke to said her doctor made her feel “old-fashioned” for wanting periods. Yes there’s some hassle involved, but many find them reassuring.

And I was not surprised that the programme didn’t consider alternatives to the pill for contraception, or for treating heavy and painful periods and acne. Or the potential health benefits – like avoiding osteoporosis - of not putting our ovaries to sleep.

Still, despite my reservations, this is a very watchable programme and I welcome women’s health being discussed on the BBC. Here’s the link.
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Using fertility awareness as contraception can seem like lots of work.

 “Log, log, log!” says your app – so surely that’s what you have to do?

Record every single day of your period, every waking temperature, every scrap of fluid.

Wake up at the same time every single day.
Never drink alcohol, or get sick, or travel, or get stressed.

Who can handle that?

Fortunately, there’s a limit to how much data you really need, and to how perfect your life has to be.

You’re not a fertility awareness failure if you don’t record every last bit of data – no matter what your app might say, or what the textbook charts look like.

More data is not better if you give up on fertility awareness when it could have been ideal for you.

More data is not better if you miss the important stuff and end up thinking a day is fertile – or infertile – when it isn’t.

Of course there minimum requirements. You do need a certain amount of data.

You do need day one of your period. This is non-negotiable.

If you can’t record day one of your period, please don’t use fertility awareness as contraception.

There are other methods – use them instead.

Luckily, thanks to all the apps out there, it is pretty effortless to record day one of your period on your phone.

There’s even a fertility awareness app called CycleBeads based on no more information than that – just day one of your period.  

It’s 95% effective, which is good enough for some, and says you are fertile from cycle day 8 to cycle day 19 – so long as your cycles are 26 to 32 days long.

What about waking temperature?

Surely you have to take that at exactly the same time every single day?

Yes, OK, it does simplify things. And it might be easier to do something every day – you could get out of the habit if you don’t.

But after the first few months you don’t have to take your temperature every day.

You could simply take it from day five of your cycle and until you have recorded three temperatures in a row that are higher than the previous six (see 3 over 6).

You can also adjust your temperature if you take it more than 30 minutes earlier or later than usual - your temperature goes up about 0.1 degrees Celsius for each extra hour later than usual that you take it, and down 0.1 degrees for each hour earlier.

How about vaginal fluid? Surely you have to keep a close eye on that?

Not really.

If you do, then your fluid can help you identify the beginning of your fertile days but you can use cycle length and waking temperature to do that, so long as you have enough data.

You do need to look out for your maximum fluid days – and when they end.

Your maximum fluid days are the two or three days each month when you see lots of vaginal fluid – and I mean lots.

The fluid on these days is usually thick, clear(ish) and very stretchy – like raw egg white.

This can be alarming if you’ve been told fluid is simply your body’s way of keeping clean.

It’s much more than that.

Fluid is how your body either welcomes or destroys sperm.

Friendly fluid can help sperm to hang around in a vagina for up to seven days (I know!).

It can also be sperm rocket fuel and mean sperm reaches your egg or eggs (think twins) in just half an hour.

Your maximum fluid days are the sperm rocket fuel days.

Be extra careful with your precautions on those days, or get busy if you want to get pregnant.

The hang-around fluid is the kind you produce before the rocket fuel – which is why you also need to use condoms or other precautions at this time.

After your maximum fluid (rocket fuel) days, there will normally be a sudden change to very little fluid - you might get some sticky or cream stuff but it's nothing like the amount you see on your maximum fluid days.

This is your body turning unfriendly to sperm. Any fluid you do produce is death to sperm – natural spermicide.

You can combine information about your waking temperature and fluid to identify the infertile days at the end of your cycle (see 3 over 6).

Of course fertility awareness data gathering and interpretation is not for everyone.

And not everyone is happy to use condoms or other precautions for at least ten days a month.  

And some women wil not have maximum fluid days – or a clear temperature pattern, especially if they have health issues.

NHS Choices says people should get support before using fertility awareness as contraception.

But you get the general idea. Data collection does not have to be a big deal.

Or maybe you disagree – or have questions. Let me know what you think.
, or comment below.   
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Using fertility awareness as contraception can mean you feel endlessly judged.

You might have noticed this in some of the recent press coverage of the contraception app Natural Cycles - which is based on elements of fertility awareness.

Apparently anyone who relies on Natural Cycles, or fertility awareness, is either
duped” or “colossally naïve”, and anyone who promotes them is “irresponsible”.

That’s not true.

Natural Cycles is not perfect - they should be open with people - but it has amazing potential.

And fertility awareness can fail – but those failures aren’t random occurrences that strike like lightning out of a clear blue sky. It can work very well.

Thanks to substantial funds and all sorts of design and marketing cleverness (I’m not so sure about their algorithm) Natural Cycles have helped many, many women use a contraceptive method that they would never have considered before.

Thanks to Natural Cycles, we have more contraceptive choice.

How is that not a good thing?

OK, so it’s not a good thing if it doesn’t work. We all want our contraception to work.

NHS Choices says the version that I teach (Fertility UK) can be up to 99% effective but there are different approaches to using fertility awareness (natural family planning). It’s basically a pick n mix of fertility indicators and effectiveness.

Some of us use fertility awareness in a very cautious way, allowing for a generous "might-be-fertile" buffer zone so we can avoid (nearly) all chance of pregnancy.

Others of us are comfortable shaving days off that buffer zone to get more green days – or cutting down the amount of data we gather to simplify our lives.

We choose how we use fertility awareness.

We use our judgement and we take the consequences.

Natural Cycles takes that judgement out of our hands - we simply trust their algorithm, and their judgement - which you might prefer.

Whatever approach you choose, fertility awareness is a reasonable option.

It might be easiest to start using it when you're not so bothered about unplanned pregnancy - TTW or Trying To Whatever is the unofficial term - but some of us will have such an intolerable time with other contraception that we’d rather use a method which doesn’t have such a good reputation for effectiveness.

We might then be pleasantly surprised and discover that Natural Cycles, or fertility awareness – or withdrawal, or condoms, or LAM (if you’re breastfeeding), can work very well if you know what you’re doing.

We need options, which is why I’ve felt uneasy about the press coverage that has focussed on individual women who have had Natural Cycles abortions or unplanned pregnancies.

They might have shared – and been asked to share – their stories with the best intentions but it has felt wrong.

It's felt like a public shaming - something designed to scare and embarrass women back onto the pill or the coil – no matter how much they dislike those options.

Of course some women love the coil and the pill, I have no problem with that, but what about the rest of us?

And what about all the women who have got pregnant using other methods of contraception– often not realising for months because the method stopped their periods - why don’t we hear about them? All contraception fails.

Women need options and shaming women who dare to use an unsanctioned approach to contraception is not helping.

Instead it encourages the idea that the only “responsible” thing for women to do is use another kind of contraception – no matter how they feel about it, or what side effects they experience – because at least it’s better than unplanned pregnancy or abortion.

Of course we want our contraception to work, but half of all pregnancies are unplanned and one in three women will have an abortion at some point in her life. Half of those women are already mothers.

Do we really want all those women to feel ashamed?

The responsible option is not to scare or shame women off Natural Cycles or fertility awareness – the responsible option is to recognise that women are often making tough choices and need support.

We should be researching how to improve the effectiveness of unsanctioned methods, not dismissing them.

I’d like to see an NHS contraception app – one that is free, reliable, beautiful and open about its algorithm. It should also make the data available to researchers. Data is the new oil - it could help us uncover all sorts of unanswered questions - we should not be handing it over to the private sector.

Nor should we be encouraging the idea that women’s bodies are an unknowable mystery that can only be uncovered by folk in white coats.

Women can learn how to use fertility awareness as contraception, it’s not rocket science.

We can also help to create better approaches. We should be co-creators – not simply consumers when it comes to using fertility awareness as contraception.

That’s why I include do it yourself guides and links on my website, and why I wrote this letter to the BMJ Sexual and Reproductive Health calling for less condemnation of fertility awareness and an NHS app.

Maybe, just maybe, the women who use fertility awareness should be celebrated, and worked with, not shamed and dismissed. We are women who are helping to improve contraceptive choice, not irresponsible or “naïve”.

What do you think? Do we need an NHS app or is it best to leave this to the private sector?

Or do you think we have enough contraceptive options and women should simply persevere with those already available?
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I wrote the letter below to BMJ Sexual and Reproductive Health in response to the article by Amy Hough et al "Social media and advertising natural contraception to young women: the case for clarity and transparency with reference to the example of ‘Natural Cycles’" (paywall). The BMJ allows publishing of paywall content on author websites so my letter is below. To see it on the BMJ SRH website click here (paywall).
In their article about Natural Cycles, Hough et al quote a Cochrane Review that dismisses fertility awareness based contraception (natural family planning).

A Cochrane Review is an understandable choice but not an appropriate one. It would be more helpful to quote NHS Choices, the Family Planning Association or Faculty Guidance, which all have a more nuanced approach to the evidence, and say that fertility awareness is up to 99% effective.

Typical use rates are lower but many women achieve high effectiveness thanks to either their own research or appropriate support.  ​
Books like "Taking Charge of Your Fertility” by Toni Weschler, websites like Fertility ​UK and apps such as Kindara, Cycle Beads and Ovuview have helped women to avoid (and plan) pregnancy for years. There is also NHS-funded fertility awareness support in some areas.​

Natural Cycles is the new app that is revolutionising fertility awareness thanks to huge amounts of funding for marketing and research and a clean design that removes all judgement from the user (in a similar way to CycleBeads) and simply pronounces a day “red” or “green”.

The accessibility, if not the advertising, of Natural Cycles is welcome. Women need options. But it is not ideal.

​Advertising is one issue. As Hough et al describe, because Natural Cycles is not a prescribed product, and because they have substantial financial resources, they are able to bypass health professionals and advertise direct to potential clients. They run targeted Facebook and Instagram adverts and get support from trusted social media influencers, favourable press articles and others.

Still, it is worth remembering that prescribed medication is also not free of commercial influence. As Ben Goldacre describes in Bad Pharma, not being able to advertise direct to consumers simply means Big Pharma concentrates on selling direct to trusted health professionals, researchers and influencers through educational events, smooth sales reps, research grants, lobbying and other methods.

Another issue is the lack of transparency about the Natural Cycles algorithm. There has been decades of research about fertility awareness. It is a shame that they are not adding to this in a more meaningful way – or even acknowledging it, simply saying that they have “invented” an algorithm, as if it has come out of thin air and not decades of research about different algorithms.

It is also worrying that their algorithm seems to have a “one-size-fits-all” approach. Fertility is not an on/off switch. There are days on which pregnancy is very likely, days on which it is likely and days on which it is very unlikely or impossible.

Some women use fertility awareness in a very cautious “life or death” way – not having unprotected sex till after ovulation has been and gone. Others are more willing to push the boundaries – depending on our cycles and on how we feel about unplanned pregnancy – and our age. A woman of 48 might choose to be less cautious than she was aged 38, or even 44.

We also use different fertility indicators. Some of us use temperature and ovulation sticks (in the style of Natural Cycles). Many women find temperature and fluid more convenient, or simply fluid and/or calendar calculations.

​A better fertility app would have a transparent algorithm that allows women to choose the approach that suits them. It would also open up the data (in anonymised form) to researchers. This is not only an important contraceptive option, it is important knowledge. We should have an NHS app for this - not a private one.
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Myself and my partner tried natural contraception with one of the high-street apps for nearly a year before we realised that following the app’s algorithm is something we can’t get used to and will never trust.

We wanted to understand the rhythm of female cycles and be able to support our intimate choices with proven studies and knowledge.

We have seen lots of doctors and nurses. It was off-putting how much rejection we faced. I asked
one doctor about using a diaphragm and she laughed at me and said they were “stone-age”.

Then we found Sarah. She empowered us both, giving all the necessary information, answering all questions and sharing her experience with us. Sarah is incredibly open-minded, knowledgeable and warm. There is no taboo with her. She’s so enthusiastic and passionate about everyone’s individual case, and she proves it with endless amount of patience.

Sarah encouraged us to buy a Caya diaphragm* from Amazon for my less fertile days - we use condoms or abstain on my most fertile days.

Caya does not fit everyone so Sarah said I should get it checked at an NHS sexual health clinic, and tell them my appointment was about Caya so I would get the help I needed.

This time my experience was completely different. The doctor was brilliant – she checked it fitted and showed me exactly how to use it. We love Caya!

My journey with Sarah and the fertility awareness method began about two cycles ago, however I was never happier with any other contraception I tried.

I think the biggest upsides are no side effects, becoming aware of one’s body rhythm, and last but not least, becoming closer with your partner as they are involved with the process, whilst learning about their partner’s womanhood.
Read more
_________________
* Affliliate link. That means you pay the same and I get a small payment. I don't link to anything I don't like.
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Fertility awareness has a terrible reputation. Never mind the Rhythm Method jokes - what about the statistics?

According to reputable sources, the typical
effectiveness rate for fertility awareness based contraception is only 75%.

That means it fails one in four women every year.

Not very encouraging is it? I'd never have started
using it with those odds.

I'm a big fan of reproductive rights. Women should have access to the contraception that suits them - and to free, safe and legal abortion services if they want them - but I have my limits.

I would not use, or recommend, fertility awareness as contraception if I thought it would fail one in four women.

That 75% statistic is a crude tool.

At best it's a handy reminder to do things right. At worst it's an unfair way to scare women (and clinicians) off fertility awareness/natural contraception. 

That said, at first glance, it seems completely fair.

It comes from the same source as the effectiveness rates for other kinds of contraception - this review of the evidence by James Trussell.

What could be wrong with that?

The main thing is the lumping together of all the different fertility awareness methods.

Fertility awareness includes a very broad range of methods.

It goes from finger-crossing, to calendar checking, to those who check their waking temperature and/or fluid.

Most of those in the effectiveness review group were using the calendar method. Only one in five of them were also checking their waking temperature and/or fluid.

So the 75% statistic really only applies to the calendar method - using your cycle day to work out whether or not you are fertile.

I don't want to dismiss the calendar method. The simplicity of CycleBeads is glorious, but you can generally get better results if you also take your waking temperature - and ideally check your fluid. 

I don't want to dismiss statisticians either. I know they have reasons for lumping together all the different fertility awareness users (mainly the tiny number of women that use fertility awareness). 

But it is rather wearing to see this 75% figure trotted out again and again.

So what is a fairer statistic? Is it the 99% perfect use figure - also quoted by Trussell and other reputable sources?

Yes, I think that's a reasonable expectation.

That 99% is based on a study of 900 women using the symptothermal" (temperature and fluid) method of fertility awareness for at least a year. Read the Frank Herrmann et al research here.

Those women might be unusual - they were prepared to be studied for starters, and they had support - but I think that's a fair statistic.

You don't have to be perfect to get perfect use effectiveness.

If you are prepared to learn a few things, record a few things, and handle your fertile days, then 99% effectiveness is a perfectly reasonable expectation.

Interested? Start by using 3 over 6 to identify the infertile days before your period - or skip straight to getting support.
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I loved the start of this film from the Victoria Derbyshire programme. At last, women with terrible experiences with hormonal contraception getting a hearing!

Of course it would be even better if women didn’t have a horrific time with side effects – or get “laughed out of the room” if they ask for help with the diaphragm – but at least they were being listened to. 
Except I was wrong, they weren’t listened to. The rest of the programme failed to follow up on the women’s concerns about side effects, or how to improve support for non-hormonal methods.

There were some warm words about the importance of supporting a woman’s choice but not much else.

Victoria Derbyshire asked if women “really needed” all these options, and only half-heartedly asked if drug company funding might influence the Advisory Group for Contraception.

Of course she didn’t have limitless time, and of course the group wants to improve women’s health - but it would still be good to ask them, and Bayer, these two questions:

1. As the film mentioned, some of the hormonal methods are very expensive, can Bayer reassure the public that they are not, like Pfizer, overcharging the NHS for their products? Especially when it comes to emergency contraception?

2. Could the group, and Bayer, sign up to the All Trials campaign for all research trials to be registered and reported? Bayer has funded a huge amount of research but has yet to join the campaign. Their research could provide huge benefits for women’s health – and help to answer some of the questions about side effects and risks.

These are important points. You don't have to be Ben Goldacre to know it's not a good look for clinicians or policy makers to have too cosy a relationship with Big Pharma, or to push their products too hard.

At the moment, many of us don't tell our doctors how we avoid pregnancy because we can't face their disapproval. We use condoms, fertility awareness, apps, withdrawal - and back it all up with a "just in case" supply of emergency contraception.

Wouldn't it be good if we didn't have to lie to our doctors? These methods can all work well, but you need to know what you're doing. We need support, not lectures. As one of the women says in this Debrief report “if we can fly robots to Mars surely we can come to understand women’s health and serve women better than we do now?”
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At the beginning of the campaign to fund this film about the pill I tweeted “Help out if you can. This is important stuff and I’m sure that Ricki Lake will do a great job.”  I put my money where my mouth is and became a backer, and then didn’t quite get round to writing a blog.

The main reason for my hesitation was I was nervous about the approach that might be taken. The film is based on the
book Sweetening the Pill by Holly Grigg Spall which is a rollicking read, but a bit rough round the edges.

Ricki Lake has said “We’re not trying to scare women off the Pill”. She says she simply wants to ask questions and educate women (and men) about their options.  Worthy goals. And yet the trailer on the Guardian website is scary. It asks “could some birth control methods kill you?” and is overwhelmingly about the heart-rending deaths of various women from blood clots that have been linked to taking the contraceptive pill. It's important that these stories are heard but spending nearly the entire trailer on them and showing a picture of a lung filled with blood clots just before a bereaved parent says “of course we want women to have informed choice” feels manipulative.

But to be fair it is only a trailer - the main kickstarter film is much better. And the Guardian did commission a piece specifically about blood clots. I’m looking forward to this film being made and to it being good, really good. Not something that is easily dismissed as “anti-pill propaganda” or “a crusade”

Millions of women take the pill for decades. We have the right to ask questions and to expect very,very high standards from any pharmaceuticals that we take for that length of time.

The trailer is scary but that's not the only scary thing when it comes to women's reproductive health. We are scared into thinking that we will get pregnant the moment we have unprotected sex. We are scared into thinking that when we do want to get pregnant we won't be able to. We are scared into thinking that abortion is a terrible, shameful thing rather than an ordinary necessity carried out by ordinary women.

Frankly I'd like everyone to turn down the whole scaremongering thing a notch. The most scary thing for most women is still an unwanted pregnancy in a country where abortion isn't free, safe and legal. Improving information and access to other methods of contraception might help some women avoid unplanned pregnancy but it's no guarantee. Scaring them off methods that might suit them very well isn't helping anyone.  

The film is financed now so I don't know how long this link will work but here it is. I'm still supporting it - in my slightly nervous and picky way. It's not going to be an easy project to get right but I wish them well.

If you want to support an uncontroversial campaign to hold Big Pharma to account then support the All Trials campaign. They're working to ensure that the results of all clinical trials are made public, not just those that Big Pharma wants us to see. I'm looking forward to the contraception trials getting a proper airing - they might, or might not, back up everything that is said in Ricki Lake's film.

And if you want to support women's access to abortion then I suggest you donate to the Abortion Support Network (for women in Ireland and Northern Ireland) and Women on Web.

_______
Conflict of interest statement – as you can tell from where this blog sits, I am an independent fertility awareness practitioner (trained and registered with Fertility UK). I make very little money from this - partly because I direct people to NHS and DIY options - so I have a proper job as well.
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