From pills to condoms, Florence Hill explores the world of contraception in the NHS, and why better sex ed is needed for young people in the UK.

The first contraceptive pill Caitlin Hart was ever prescribed was the now-discontinued Cilest. Less than 24 hours after taking her first dose she was struggling to breath and fainted.

“When I went to the doctor, he told me the sexual health clinic I had been to shouldn’t have prescribed this particular pill to someone who hadn’t used hormonal contraception before, as the hormone levels were far too high,” says Caitlin.

“From then on, I was put on several different pills, and had to change prescription every three to six months because they all gave me different negative side effects.”

Despite tremendous improvements in the sexual education curriculum over the last century, we are still not quite where we need to be. People are lacking information on sexual health and it seems to be something we still feel uncomfortable discussing.

Many teenagers and adults take contraception for other purposes, such as to help with periods and acne. Following the combined oral contraceptive pill being approved as an acne treatment, researchers saw an overall increase in the number of young people taking it.

However, sometimes the effects of using them are only fully understood after people start taking them.

Louise Floyd, a student at the University of Birmingham, has had a difficult journey on the pill. She says, “I felt a bit lost. I didn’t know where to go for medical support when I started having problems.

“It should be possible for either person in a relationship to take some form of birth control. Currently, responsibility is placed on women because quite a few methods are aimed at us.”

Louise feels that the side effects of contraception, especially the emotional ones, are often understated in the information available to the public.

Amanda Ainsworth is a nurse in Shropshire who prescribes contraception as part of her role. She believes education about contraception is lacking at younger ages. 

“When delivering education, it’s crucial to include things like consent, the laws, risks and benefits of types of contraception, and relevant personal or family history,” she says.

Issues such as consent, grooming, and abuse can identify themselves during consultations. Amanda says if a parent is present at a face-to-face or phone call, in this case, they ask to speak to the young person alone for a few minutes.

She adds, “People are sexually active often in their early teens now. The teens I deal with usually have a parent with them, who they have discussed beforehand. 

“Teens would probably find it difficult to come face to face without a parent knowing, but contraception advice and prescriptions can be dealt with over the phone, and young people can speak to a doctor or nurse that way.” 

Darlaine Honey is an NHS sexual health advisor who works some sessions in a young persons’ clinic. 

She says, “One of the first questions I ask is always what the young person knows about contraception and sexually transmitted infections. Knowledge of this kind appears to be very low. 

“Primary education regarding conception, condoms, the pill, and so on is relatively common. But information about infections, viruses, HIV, herpes, and prevention is not.

“From a sexual health perspective, my ideal would be to see regular sessions at school for a whole term, where pupils could speak with sexual health staff from an external source. Young people could be guided, educated, and empowered with correct knowledge. 

“They seem to use ‘Dr Google’, or rely on friends a lot, which is not helpful.”

Dr Naomi Sutton is a Consultant Physician at an NHS-integrated sexual health service. She explains, “Education about contraception is hugely important for women. It has one of the biggest impacts on advancing women’s equal rights.

“It allows women to decide whether or when to have children, which allows them to control their physical, psychological and social well-being. This has allowed women to have more equal career choices and pay and, perhaps as importantly, separated women’s sexuality from childbearing.”

Simply put, when an individual can control and understand their fertility and meet their reproductive health needs, other aspects in life become easier to control.

Dr Sutton adds, “Complete and comprehensive education about contraception choice is vital.

There are great sources of information about contraception widely available online, but the influence of a friend, parent or teacher can still be more powerful. 

“We need to dispel myths for facts.”
Resources such as the contraception choices quiz and the NHS contraception guide are available for those needing more information on the options available.

A indication of the need for more education around contraception comes when you ask people to name different contraceptives. So that’s what we did. We tested four 20 year old men to gauge their knowledge on the variety of methods available.

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