Birth control is a vital medication for those with reproductive health issues, but for those in the United Kingdom (UK), Brexit may be putting their access to this and other medications manufactured outside the UK at risk. There are different laws for drugs being imported between countries that aren’t part of the European Union (EU) compared to those inside it. Some companies are expected to struggle to keep up with changing manufacturing costs. And some disabled people are already facing shortages.
Around 3.1 million people in Britain use a contraceptive pill and rely on them to carry on their lives without having to worry about heavy, painful periods and debilitating ovulation. Birth control can regulate periods, allowing those who take it to have either a much more regular period or none at all. For those with endometriosis, polycystic ovary syndrome (PCOS), or generally painful ovulation, birth control is known to control pain. For those with premenstrual dysphoric disorder (PMDD), birth control can help realign hormones and stop intense mood swings. It can also help with the mental and emotional symptoms sometimes associated with reproductive health that aren’t always considered, such as migraines, irritability, trouble sleeping, depression, and anxiety.
Since having a hysterectomy three years ago, I was on the Sayana Press contraceptive injection up until October of last year. I took it to control my ovaries as I was still experiencing debilitating cramps and painful ovulation. It would get so bad that I would end up in the emergency room doubled over in pain.
However, when I was due my last injection in September, my doctor was unable to get it due to manufacturing issues. It was reported that there was an “interruption of supply” due to a manufacturing issue at the main Pfizer plant in Belgium, where Sayana Press is made. There was also a subsequent recall of batches in October because some units weren’t sealed correctly and could’ve faced contamination in transit, and some batches had an unreadable expiry date.
So, I had to take the generic Depo Provera version of the injection. I had painful cramps nearly every day for three weeks and on some days, could barely get out of bed.
The final straw was when I ended up in the emergency room the day before my honeymoon and almost missed my first vacation with new husband because of the pain. When given the choice, I chose to start Zolodex treatment which would induce a chemical menopause, knowing that I couldn’t live with the debilitating pain I was experiencing while taking the generic brand of the contraceptive injection.
A resupply of Sayana Press is expected in the first quarter of the year, but this also coincides with Brexit. And it’s not just Sayana Press that’s affected. People in Britain are already struggling to get hold of many of the most popular and common birth control pills. While the leading brands have confirmed there are problems in the manufacturing process, they are unable to give any indication of when it will be resolved.
Some manufacturing problems got so bad that the drug companies chose to discontinue the medication instead of trying to resolve issues. Two of the most popular versions of the “combined pill” (a contraceptive which contains the hormones estrogen and progesterone), Cilest and Loestrin, were discontinued in October, after months of manufacturing issues.
Doctors are advised to offer patients alternative generic birth control, but often patients aren’t forewarned about this. For many people with reproductive issues, birth control is an uphill battle that can take years, going through many different methods and brands before finding the right one for their body. So, a sudden change of birth control medication isn’t a safe option.
Take Cath, for example. After 10 years of pain, stress, scans, and trying many other forms of contraceptives, a gynecologist prescribed her Rigevidon, which has a lower dose of hormones than other combined pills. She also has epilepsy.
“My periods are extreme,” says Cath. “I can fill a menstrual cup in 1-2 hours and this lasts for 2 weeks. The pain was unbearable. I used to faint, have seizures and I couldn’t walk. I was prescribed Rigevidon so that I can live normally again. It’s vital for my quality of life.”
As Cath relies on her pill so much, upon seeing online that there were potential shortages, she consulted her pharmacist. “They said it was taking longer to get some medications and they were already stockpiling. They gave me an emergency dose while I waited for the full amount. In the end it took nearly a whole month instead of the usual 3 days.”
Cath was offered an alternative combined pill, but having dealt with this pain and stress for 10 years she was understandably upset. “They know my periods caused a mental breakdown before, so to try and suddenly change it like that is irresponsible and negligent care.”
It’s hard enough to be believed when you tell medical professionals that you have chronic reproductive problems and pain. The average time from start of pain to diagnosis of endometriosis is 7 years, with some taking over a decade to get a diagnosis.
I struggled for years to have my pain taken seriously, with many doctors dismissing it as just a painful period. The worst insult I ever received from a doctor was “maybe this is just the level of chronic pain your body needs to get used to.”
As a disabled person, the thought of suddenly being given a new pill after finally finding one that works is a terrifying idea and one that would certainly cause me distress. It feels like having a safety net suddenly pulled out from under you. There’s no certainty as to what will happen with medication manufacturing after Brexit, but the way its already going makes it clear that disabled people are bound to suffer.