Wish There Were Better Contraceptive Options? Here’s 1 Thing You Can Do Right Now

Wish There Were Better Contraceptive Options? Here's 1 Thing You Can Do Right Now

Get yourself a Yellow Card

Contraception Tarot Cards

A staggering 90 to 98% of all adverse drug reactions are never reported

Have you heard of The Yellow Card Scheme? I worked in the NHS for two years and didn't hear of it once. It’s a wonderful nationwide system for collecting data on all the suspected side effects of medications and medical devices.

Completing a Yellow Card only takes a few minutes and can be done by anyone; patients or relatives, doctors or pharmacists. There is even an app you can download on iOS or Android. You simply answer a few questions about the side effects you have experienced from a certain drug - and that’s it. The Yellow Card goes off to the MHRA (Medicines and Healthcare products Regulatory Agency) where the data is used to help prevent similar incidents in the future. The information may also be sent off to the manufacturer so they can further investigate the issue.

But a wonderful system is not much good if no one uses it (although there are those that have some very valid criticisms of the scheme overall). Numerous investigations have long concluded that under reporting is a major failing of the Yellow Card scheme. Around 90% of all major ADRs (adverse drug reactions) are never reported and 97% of all non major reactions are never reported. (The figures for the USA are similarly high)It’s pretty startling to learn that the overwhelming majority of all side effects are ‘officially’ ignored, and does make you wonder whether we might have a rather skewed representation of how safe and effective our drugs really are…

Aren't doctors supposed to record information about the side effects their patients experience?

In many cases no one in the medical field will even know about any side effects because, for example, the woman will simply stop using the particular contraceptive (FYI getting pregnant whilst on contraception is a medication failure and should also be reported). Besides, even if a GP or pharmacist is informed they will often not fill out a Yellow Card at all and thus the MHRA will still not receive the information it should.

Pink Bubbly
Accurately predicting contraceptive side effects can sometimes take a bit of magic. But reporting them only takes a Yellow Card and increases safety for you and everyone. Then you can reward yourself for doing a good deed with something fantastic and bubbly

And perhaps The Nurse you confide in will gently inform you that the impenetrable cloud of depression raining misery upon your whole life is simply a case of ‘boyf issues’ and nothing at all to do with the The Pill you’ve just started taking... And then instead of a Yellow Card you'll get a look of pity and a pat on the arm.

Particularly with contraception it is of the utmost importance that users fill out a Yellow Card themselves because all too often women's complaints are ignored or their concerns dismissed. Even if it's only a suspicion that your contraception has caused a certain reaction it is still important to report as it helps build up a bigger picture. Rare or delayed effects can be discovered even after medications have been available for years; for example Reye's syndrome was associated with aspirin EIGHT DECADES after it was first marketed. Mental health issues are of course just as important to report as any other physical symptoms.

Wish there were better contraceptive options?

In the UK especially, where prescription medication is not advertised, we are removed from the fact that we are active consumers in the medical world. It is easy to forget that the drugs we take are products manufactured by billion dollar pharmaceutical companies and that consumer feedback is what drives product development.

Not only should we report side effects with the hope of eventual product development; it is simply a hugely important part of pharmacovigilance overall. Clinical trials alone are not adequate in determining long term safety and therefore patient reporting after drugs go to market is vital.

The sample sizes in most clinical trials are often too low for the detection of rare ADRs, and are unable to detect ADRs with long latency periods. Most systems utilized for post-marketing drug surveillance rely primarily on spontaneous reporting.Improving reporting of adverse drug reactions: Systematic review 

In the case of hormonal contraceptives more patient feedback could allow prescribers to better predict how individual women will respond. Some general patterns are already known; such as that teenagers are most vulnerable to the effects of depression from hormonal contraceptives and that older women who smoke are far more at risk of thromboembolic events. But at the moment deciding which contraceptive to use is pretty much a straight up gamble, with advice that amounts to ‘give one a go and see how great you feel or how f*cked you get!’

Reporting side effects is the first step towards safer and more predictable contraceptive methods for all.

If you suspect you have experienced side effects from your contraception go fill out a Yellow Card. You will then have done your good deed for the day and are therefore free to do something heinous later on like wee in your gym’s hot-tub or drink all of your housemates’ wine.

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