Some women experience side effects from certain types of contraception that are not mentioned in the medicine pamphlets, says Nevine Hassanein, M.D. and Ob/Gyn Consultant & Public Health Specialist. Because of natural hormone changes, depression, increase in weight (specifically in the abdomen)and mid section, water retention, hot flashes, intense mood swings, heavy bleeding and nausea are all symptoms that women are prone to feel some time in their lives. There are, however, external factors which cause inconvenience to many women. Birth Control, in its myriad forms, is one of them. Some side effects are documented while others are based on observation. Reham al-Kady, 31 started using birth control pills when she first got married. After four months she gained 15 kilos and started getting intense mood swings and depression. It took Kady one whole year to realize that the pills were the cause of her problems. A friend of hers using the same pills at the time did not feel these symptoms. Rasha Mahmoud, 32, was using a hormonal loop for two years before she felt she had to give it up. She had water retention, which made her fingers and toes blow up and caused great discomfort. In her same circle, two of Mahmoud's friends also felt discomfort. The one thing they had in common was that they all used the same product. One of her friends had her menstruation completely disrupted. Another friend felt depressed, had gained a lot of weight and occasionally felt nauseous as well as having her cycle disrupted. All three of them changed the form of birth control and within a month the symptoms disappeared. Hassanein says the method of family planning has to do with family status, history and previous pregnancies. It is important that women receive counseling on contraception, says Hassanein. Hassanein says each type of contraception has pros and cons for different types of people. Due to the different side effects of birth control, proper counseling is extremely important. A high discontinuation rate is due to the lack of counseling and understanding. While many women want to practice family planning, the discomfort they feel may cause them to discontinue birth control. “Quality of life is extremely important as well,” says Hassanein. Eman Ibrahim,23, whose education stopped at the equivalent of high school, learned about the different kinds of contraception from her local health center when she went to get her first tetanus shot. At the time, she was six months pregnant with her first child. She is now a mother of two. When asked about contraception, she appeared well acquainted with the types. “I used IUD as soon as I finished my 40 days after birth,” she says. “They told me to use the pill with one hormone but I preferred IUD from the first time I used it. Now it is causing heavy bleeding and I want to change it.” A Demographic Health Survey conducted on behalf of the Ministry of Health in 2008 showed that 99.7% of married women had knowledge of family planning. The most familiar types are pills, IUD (known as the coil or loop) and injection. These are the ones that Ibrahim cited when asked about her options. Most of her knowledge was obtained from the media, newspapers, television and radio. Ibrahim frequents her health center regularly and says the doctors and nurses give them good female counseling concerning family planning. But Ibrahim says she wishes they would hold more seminars in her health center in order to raise awareness surrounding more health issues. Hormonal forms of contraception have side effects on women. However, the amount of hormones in each type of contraception differs. When patients are aware of how their body works, they will be able to pinpoint the cause of discomfort and do something about it.
