My recent experience in trying to acquire the contraceptive pill Destrogel has been somewhat of a challenge. As with any trip to the GP, I armoured myself with a thick shield of perseverance and an unbreakable spirit of patience. I was drawn to write about this as I am sure many other menstruating people have faced similar difficulties, and I would feel my own stress from the situation would be justified if even just one other person related to it (although looking online, I am bombarded with Reddit entries and news articles with tense headlines that make me think I am not as alone as I thought).
“Why don’t doctors care about women’s health?” 1
“The lack of knowledge and care for women’s health through the NHS is appalling.” 2
The below is taken from “Results of the ‘Women’s Health – Let’s talk about it’ survey” 3
“More than 4 in 5 (84%) went on to tell us there have been times when they (or the woman they had in mind) were not listened to by healthcare professionals.
Tens of thousands of examples were submitted. Based on our thematic analysis of this data, ‘not being listened to’ appears to manifest at all stages of the healthcare pathway. Specifically, many women told us:
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their symptoms were not taken seriously or dismissed upon first contact with GPs and other health professionals
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they had to persistently advocate for themselves to secure a diagnosis, often over multiple visits, months and years
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if they did secure a diagnosis, there were limited opportunities to discuss or ask questions about treatment options and their preferences were often ignored”
My belief is (and I am sure yours is too) that contraceptive pills for those with intense and debilitating periods, or just menstruators who don’t wish to have their uterus lining pulled out every month, should be safely and easily accessible, with or without transport.
Periods have always been a monthly 404 error of pain, nausea and debiltation. For me, they also include collapsing legs and a lot of time spent on the bathroom floor. To state the obvious, none of this is enjoyable. I have been on the Destrogel pill for quite some time and recently switched to the Depo jab. My partner had fractured her wrist and was my only source of transport, so there was little chance of getting to the surgery. My Depo jab ran out and as I couldn’t get to the doctors, I requested an emergency supply of the pill to hopefully cover the gap where my body was not receiving any contraception.
I had been told by the receptionist and the first pharmacy I visited that I needed a review if I wanted any more of the pill next month. I explained that I had no transport to the doctor (I had managed to get a lift this time but this wouldn’t be a regular occurrence) and their answer was:
a). Go to the doctor (3.6 mi) which would be £8.95 – Uber
b). Go to a pharmacy (3.4 mi) which would be £7.91 – Uber
c). Go to a sexual health clinic (14.1 mi) which would be £22.90 – Uber
Yeah. No.
So, I took it into my own hands and researched the questions that the doctor would ask. This included any side effects, new symptoms, newly diagnosed illness (such as migraines), history of family blood clots, other medication I am taking, height, weight and blood pressure. I wrote this all up in a concise email and sent it to my GP, also adding a note regarding my transport issues. While I was waiting for a reply, I looked at other services.
I found the website “Superdrug Doctors” which issues a wide range of brands of contraceptives ranging from £17.99 to £80. “Post My Meds” seemed the best bet, as you could get 84 tablets for £18.99. Others I found were Zava with prices starting from £12.99 and Chemist 4 u which stocks the Hana brand I mentioned later on for only £8.59.
When the GP reception team rang me back, they said that I would need to come in. I explained once again I couldn’t. I had sent all the information required and I was very happy to have a phone call/ video call with the doctor or supply any more information. The receptionist was very assertive that this was the only way and that they needed to check my blood pressure (which I already supplied). I asked if there was any other way of getting it and she insisted that she was just repeating what the nurse had said. I mentioned that I would have to stop taking it then, to which her reply was:
“That is not advisable.”
“Ok, how else can I do it then without transport?”
“You can go to the sexual health clinic.”
This requires transport.
I ended the phone call in irritation. There are many reasons I cannot drive: dyscalculia and dyslexia which alter my vision and distance skills, poor vision in low light, neurodiversity which affects my multi-tasking skills, and medications that I am already on. I have also been barred by the DVLA which deemed it not safe for me to drive due to my learning difficulties and mental illness. Not to mention I have no money for lessons, a car, insurance, petrol even. So if I am to judge this from their prior actions, I would say this GP surgery is not at all inclusive of my disabilities and personal struggles. The area in which I live and the location where the GP surgery is are both very rural, and it surprises me that inadequate systems are set in place for those who cannot drive, have disabilities that prevent them from travelling or don’t have suitable carers or help from friends and family.
Contraception should be accessible to all wherever they live and in any form that it can be received. It is unjust to be denied it for reasons beyond the patient’s doing. Measures should be taken to ensure it is accessible for all and there is equity for each individual case so no one is left behind or has to live in pain in a country where medication is readily available. There can be phone calls or video calls arranged, online forms to check any new symptoms – AI could even lend a hand.
Later in the week, fuelled by pure irritation and in the spirit of Stacey Dooley, I visited the pharmacy inside Tesco Extra and talked with a lovely till assistant. I asked if they had any Destrogel. After checking with the pharmacist she handed me over a month’s supply of Destrogel ( from the Brand Hana priced at £19.99). There were no blood pressure, weight or health checks: it was just handed over. I asked for advice on getting free contraceptive pills as even the till assistant agreed that £19.99 is extortionate. She told me to visit other pharmacies as some will review you and send the results to your GP. But ultimately I can go to any pharmacy and purchase Destrogel without any prior health checks.
These findings completely hypocrisies the GP’s need for a review. I can seemingly visit any pharmacy and purchase contraceptive pills without the need for a health review. So does this mean the reviews aren’t needed or that pharmacies are selling them unsafely?
On the NHS website, it states:
“You’ll speak with a pharmacist in private. They’ll ask about your health and may check your height, weight and blood pressure.
“If the pharmacist gives you the contraceptive pill, they will tell your GP, but only if you give permission for them to do so. This information will not be shared with anyone else.
“If you already have a prescription for the contraceptive pill, you can use the prescription as usual. Or you can get the pill from a pharmacy without a prescription if you prefer.” 4
So that means you can either spend roughly the cost of a normal prescription to over £80 and receive a contraceptive pill without needing to see a doctor, or receive it for free and deal with the fuss of your doctor. It does mean you will be taking your health into your own hands, but if you have a blood pressure monitor and a notebook you can easily monitor your own health.
For me, it’s more likely I’d be able to purchase the pill from my local Tesco pharmacy than the doctors, as it’s closer and more regularly visited by those in my household. Or I could just order it online and not have to find transport at all.
I can’t seem to find an answer for the “on and off” reviews. If there has been some new radical change in the contraceptive world where reviews are no longer needed, none of the menstruators around me were aware or alerted to this.
The issue of attitudes towards menstruators’ health and the rage-inducing hurdles you have to cross to get the help needed often comes up in conversations with other period experiencers, and no one seems to know the answers. For those with low incomes and no transport, it seems contraceptives are very difficult to obtain. I personally cannot find anything online that will send them to your address at no cost. Similarly, it is nearly impossible to find free sanitary items, with Scotland being the first and only country to offer free sanitary products. This shows that periods are still a big issue and I think we have a long way to go before this is no longer a concern for so many.
Here are some brilliant charities you can donate to and share online to help support the cause of ensuring we all have efficient and safe access to sanitary and contraceptive products:
Citations
An interesting topic. Modern day menstruation – essentially women are still not accepted as they are, still emotional rollercoaster. Women’s bodies are designed to sustain another life, and with it comes the ability to manage an array of sensations. It’s cycle is highly variable betwen women as well as for each woman. Historically the patriachral couldn’t explain it – the men, as the self-decalred leaders of society spread their lack of understanding of the concept and leading to women being burned, quite literally. Todya in our modern world the medicated state of control rather than the older more violent methods seems to be the norm. Acceptance of emotions and emotional variations is a more natural female state than it is for the male state. As sciences are learning more the accceptance of these differences is slowly becoming more wide spread.
Hi Nichola – thanks so much for reading and commenting; I really appreciate it! You have a very interesting and true response. I really like your point about how there is a “medicated state of control” – that is such a brilliant point! I also like the “manage an array of sensations”. Thank you for your thoughts 🙂