“The combined pill has a mix of the hormones oestrogen and progesterone, preventing ovulation. Brands have combination pills with either different types of progesterone or different doses of oestrogen.”

“Some pills, called minipills, only contain progesterone and prevent pregnancy by making the cervical mucus thicker and the lining of the uterus thinner. Minipills with higher concentrations of progesterone can also stop ovulation, but unlike the combination pill, the minipill is not usually used for hormonal regulation.”

Apart from birth control, the contraceptive pill can also help ease the symptoms of many health conditions, “such as migraines (although it can also cause migraines in some cases), menstrual pain, endometriosis, heavy menstrual flow, or acne. The pill is also linked to a lower risk of ovarian, endometrial, and colon cancer, and is an essential mechanism to treat polycystic ovarian syndrome.”

However, here it is important to note that in many cases, the pill eases the symptoms of these conditions only when one is on it – meaning that it is not a permanent fix.

The Bad

“However, no medication comes without its risks. The main side effects of the pill include weight gain, loss of sexual libido, and mood swings. Rare side effects include a higher risk of thrombosis and pulmonary embolism.”

Stabile further revealed that most of her patients in Malta worry about “weight gain, irregular bleeding, changes in body hair, and the contraceptive not working. She also confirms that some types of contraceptive pill can cause mood changes, vaginal dryness, and loss of libido.”

Through her practice, Stabile tries to regulate the side effects by altering the doses hormones.

“Because there are several different types of combination pill on the market, physicians can tweak the dosages to control patients’ side effects. Other consequences can be tackled with different mechanisms. For example, vaginal dryness can be addressed by using lubricants.”

The Ugly

“In Malta, more people need to know about the side effects of the pill. There is a lack of information,” Stabile told Think Magazine.

The side effects addressed so far reduce the quality of life of those who get them and are the reason why one third of women stop taking the pill in the first year. Yet there are other side effects that are understudied, the magazine wrote.

“Changes in cognition and decision making, as well as deterioration of emotional well-being, have been reported as possible side effects of the pill. Users of the contraceptive pill also seem more likely to have depression and anxiety. Women have reported debilitating migraines that lead to seizures, and besides changes in libido, some research (not all) shows alterations in sexual attraction.”

“It is worth mentioning that all these side effects have previously stopped the development of a male contraceptive pill. These small-to-hefty side effects can also be found in other hormonal contraception methods, such as the patch, hormonal intrauterine devices (IUD), or the vaginal ring,” the magazine continued.

Contraceptive pills in Malta are unsubsidised, meaning that they are paid for by patients in full price. In general, there is no free contraception in the public health system and only emergency contraception and condoms are available at pharmacies without a doctor’s prescription.

Similarly, contraceptives aren’t covered by the state’s health insurance and free condoms are only handed out by private and non-profit organisations. 

According to a UN working group on discrimination against women and girls that visited Malta in July 2023, the lack of access to affordable contraception pushes women to forgo protection and rely on what’s known as the pull out method which is not officially considered as contraception.

The working group further recommended the state to provide free contraceptives to certain groups, the magazine stated.

“Malta also has a lack of official data on the population’s contraception usage, unplanned pregnancies, miscarriages, or abortions. Most of the information available online comes from reports from international organisations or small academic studies, and the information we do have is not optimistic.”

“Malta’s relationship with contraceptives seems dire, which considering the need to upgrade sexual education at schools, the lack of public awareness towards safe sexual practices, and the existence of methods with so many misunderstood side effects, comes as no surprise. The upside is that, by empowering the population with correct information, good practices can become the norm.”

The magazine concluded by saying that researchers and pharmaceutical companies need to continue the work “to understand the pill’s impact on women’s health”.

Would you ever take the birth control pill?