Across the world, there are 1.9 billion women of reproductive age. According to a 2021 study from the World Health Organization, 1.1 billion of these women want to use birth control, with 164 million of these having an unmet need for contraception. This is despite a wide range of options being available to women, with more than 13 types and over 200 brands of contraceptives available worldwide. The majority of the 874 million who are using contraception currently use hormonal methods, including the pill, implants, and intrauterine devices.
Finding the right method
Prevention of pregnancy is not the only reason women use birth control, with heavy periods, irregular cycles, or hormonal acne all being issues that can be alleviated through contraception. The variation of these motivations—alongside factors such as ethnicity, post-natal status, perimenopause, mental health, and use of other medications—means that finding the most suitable contraception can often be a long-fought battle, with women often going years experimenting with various options and struggling for months with an onslaught of side effects.
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On average, women experiment with 3.4 different birth control methods throughout their lifetime. The most common reason why they might stop taking a certain type of contraception is the side effects, which can include migraines, blood clots, irregular bleeding, nausea, and significant changes in emotional well-being. These effects often have the potential to perpetuate mental health issues, making the experience of taking contraception all the more confounding. Alongside having to test out which birth control works best for them, women must contend with their everchanging hormones as they age: puberty, potential pregnancy, and menopause all produce vastly differing hormonal levels that the body must adjust to. Individual needs change, and certain fixed factors, such as regular medication, may elicit different reactions in combination with their chosen contraceptive method.
Essentially, contraceptives must be tailored to meet an individual’s specific requirements. This is currently not the case. Women must go through the ordeal of experimentation, often being put off birth control altogether as their bodies endure a cocktail of hormones affecting their physical and mental health.
Links discovered between genetics and birth control side effects
New research and technology have recently demonstrated how contraception for women can be personalised based on genetics and individual needs. The Yale School of Medicine examined how genes impact the body’s response to hormonal birth control, discovering several genetic differences that could affect the chance of contraceptive failure and the experience of certain side effects.
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Significantly, it was found that a variant of the CYP3A7 gene could increase the metabolism of etonogestrel, a hormone released by the implant. If a woman has this variant, the hormone breaks down more quickly than average, reducing the effectiveness of the implant. According to estimations, around 5% of the population has this variant. This means that a significant proportion of women are unaware that they are more susceptible to unintended pregnancies.
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By GlobalDataThe same team at Yale also identified a genetic variant in the estrogen receptor gene that was associated with substantial weight gain when using the implant. Weight gain is a side effect of hormonal contraception that will often lead to its use being discontinued, yet is debated in the medical field as to its legitimacy despite it being a common complaint.
Personalised medicine offers a new hope
Personalised medicine is a relatively new field of research yet has the potential for significant impact. The variation of side effects for contraception methods such as the pill and the coil can be overwhelming and confusing, with women experiencing difficulty in attributing their presented symptoms to the birth control itself, and often having to deal with the perplexing notion that there may be something else wrong with them, either mentally or physically. Most certainly in the avenue of contraception, personalisation could be a lifeline for women struggling with various methods of birth control, which can have years of impact on their well-being. The development of personaliszed medicine is a crucial moment in the history of women’s health.
