When Kripa* decided to start using contraceptives five months ago, she turned to Google to figure out which one to buy. “I didn’t want to go to a gynaecologist because most of them ask embarrassing questions and I’m unmarried,” says the 22-year-old makeup artist from Mumbai. Her random Google search informed her that the emergency morning-after pill was rated five stars. So she bought a strip and began popping them as contraceptives.
Two months ago, she began to feel severely nauseous and bled very heavily during her period. “I looked up the possible causes on the internet, tried a painkiller that a friend suggested, but nothing worked,” she says. Finally, last month, she sought out a doctor. The gynaecologist told her it was a case of faulty contraception.
The case of PR executive, Kriti Rathi*, 21, is somewhat similar. She saw a gynaecologist recently with complaints of irregular periods, it did not take much time for her doctor to figure out the reason.
Rathi had a habit of popping in the morning-after pill whenever she had unprotected sex. On an average, she had been popping two-three pills in a month for the past couple of years, sometimes even back to back. For the past 6 months, she was experiencing irregular periods, and decided to consult a doctor.
Across urban India, doctors are becoming increasingly concerned that, as girls start to have sex younger, and at the same time develop an unfounded trust in the internet, they are self-medicating when it comes to contraceptives, with potentially disastrous results.
“Many young women — including minors — do not realise that starting regular contraceptive use without medical supervision can have severe health effects,” says Dr Charusheela Sabne, gynaecologist at Pune’s Sahyadri Hospital.
“The emergency morning-after pill, for instance, is not meant to be taken on an ongoing basis, and can cause irregular menstrual cycles, loss of fertility, hormonal imbalances, cramps and nausea if misused. Overall, regular contraceptive use without medical supervision can also cause serious health hazards such as cervical erosion.” Emergency contraceptive pills or morning-after pills may be available over-the-counter, but experts warn against using them in place of a regular oral contraceptive. “It is an emergency measure and must be taken only in dire circumstances. It is not safe to use an emergency contraceptive frequently,” says Dr Bandana Sodhi, senior obstetrician and gynaecologist at New Delhi’s Moolchand Hospital. Dr Sodhi sees about three to four women in a month who have had a habit of using emergency contraceptives frequently.
The frequent use of emergency contraceptive pills has side effects. Also, these pills have a high failure rate.
“If a woman is having three-four pills in a month, why can’t she go for regular contraceptive methods,” asks Dr Tripat Chaudhary, senior obstetrician & gynaecologist at Fortis La Femme, Delhi. “Taking these pills once in a while is ok. But frequent use messes up your periods. You don’t need these pills if you don’t fall into the fertile period, and only a doctor will be able to tell better,” says Chaudhary.
On the internet, anybody can present themselves as a pregnancy and contraception advisor. “We are seeing a rising number of cases of gynaecological complications and even pregnancy where contraception was used. Unfortunately, young people do not know what kind of contraception should be used, or how it should be used,” says Dr Anita Soni, a gynaecologist at Mumbai’s super specialty Hiranandani Hospital.
Dr Madhuri Laha, consultant for obstetrics and gynaecology at the Columbia Asia Hospital in Pune adds that girls as young as 16 are reporting such complications.
Meanwhile, technology is marching forward. In November, the union health ministry announced a mass roll-out of injectable contraceptives to help widen contraceptive choices for women.
Though no contraceptive method is 100% effective all the time, doctors prefer a regular pill if one is sexually active and doesn’t want to conceive.
It is mostly the myths surrounding the oral contraceptives that deter women from taking them regularly. “The newer generation of pills are low dose and don’t lead to weight gain or other side effects like nausea,” says Dr Sodhi. “There is no lack of choices; the problem is lack of information and awareness,” Dr Laha says.
The ideal contraception varies according to the age of the woman, says Dr Sonal Kumta, consultant gynaecologist at Fortis hospital, Mumbai. “You should not choose your own contraception. Always get advice from a doctor,” she adds.
Counselling for girls and their mothers is the only way. “The fault lies in the system as there’s easy access to most drugs, and no proper sex education,” says Dr Chaudhary. “Counselling is an art, so for it to work with a teenager one has to be extremely patient.