Interview 51 - Stefanie

Age at interview: 24

Brief Outline: Stefanie used depot injection for about eight years since the age of fourteen to help her coped with very painful periods. At the moment she is using two forms of contraception; the implant and oral contraceptive. Stefanie is considering the coil but would like to hear from women who have experiences of using it.

Background: Works as a production assistant, lives with partner and she is looking for an alternative method of contraception to the implant.

More about me...

At the age of 14/15 Stefanie started to use the Depo Provera injection because it was the only thing that helped her cope with painful periods. It wasn’t until she was 18 that she found out that the Depo Provera - if given before the age of 17 might cause osteoporosis. Until then, she has been happy on the injection because it stopped her periods. She used it for about eight years.

Stefanie finds combining full-time work and the long waiting in Family Planning clinics difficult. She decided to stop using the contraceptive injection after she started work. Her periods came back and she started using the depot injection again but her periods didn’t stop as before and instead, they became irregular and unpredictable. She went to a Family Planning Clinic for advice and Stefanie thinks she was given bad advice. She was recommended she change the injection for implants to stop her period but it didn’t work. At the time of the interview Stefanie was using the pill and waiting to have the implant removed. The contraceptive pill helped normalise her period but after three months they have become erratic again meaning she has constant spotting.

Her dual method of contraception came about because the contraceptive pill and the implant were given by different Family Planning clinics. She has informed both clinics about this. Stefanie lives in a busy urban area and uses whichever clinic can fits her in. Stefanie obtained her oral contraceptive; Femodene, from a nurse but on her last visit, she was told she needed to see a doctor but there was no doctor at the clinic.

Stefanie has tried all contraceptive methods, except the coil, and finds oral contraceptive a good option but she is also researching the coil. Remembering to take the pill every day is Stefanie’s biggest problem so in order not to forget, she keeps her pill with her toothbrush, or set an alarm on her mobile.

She describes her GP practice as ‘traditional’ and not really engaging with young patients. For example, she said that she wasn’t offered a Chlamydia test and at age twenty-three, she had to go to her GP and ask for one. The results were negative.
 

The one thing that helped Stefanie with her painful periods was the Depo Provera injection.

When I turned, it must have been about 14 or 15 and I was very young I started with very, very painful periods. And they tried numerous methods to try and help me. First of all painkillers and finally they switched to trying me with the pill because they thought that would help. And what I found was that it was making me ill at night. So eventually at the age of 14, 15 they put me on the depo [Depo-Provera] injection which wasn’t widely spoken about when I was younger and not a lot of research had been done for it.

It was only when I turned 18 that research came out that suggested you might be susceptible to osteoporosis if you have it before 17. So that made me feel a bit nervous but I have to say I loved the injection because it stopped my periods completely which as a girl and anyone can relate to, it was great.
 

Difficulties in accessing the same clinic for sexual health meant that Stefanie had the implant done in one clinic and the contraceptive pill prescribed in another.

So why did they suggest you use both methods at the same time? What did the doctor say?

 

Part of the reason is because I have been going wherever I can be seen so it would be that I’ll go to one clinic, in [city area] because they can see me and they will advise me to. They, well actually I went in saying, ‘I wanted to try the implant’ and they gave me advice and they gave me the implants. And then I found out that it was going to be, it was making my periods really irregular. So that’s when I couldn’t get back into [city area] because they were very busy so I went to a different clinic in [city area] and they gave me a pill to help me sort it out. So it’s different people, it was never the idea to go on both at the same time originally.

 

Ah ok but did they know that you are on both or you were on both?

 

Yeah uh huh.

 

Ok and what was their opinion about it?

 

They just said it would kick start my cycle into sorting itself out and then it would hopefully after three months be more regular and normal. But, but that didn’t happen. So I went back last week actually when I saw your advert. And I asked if I could get the pill again and the nurse refused and said that I, only a doctor is allowed to give you the pill when you are on the implant already which wasn’t what happened the time before. So…

 

Ok because you were given each thing in two different clinics at that time?

 

I think so yeah.

 

So you will go back to see the doctor and discuss?

 

That’s right yes I’ve booked an appointment to just discuss all my options because I think that’s what’s most important. People just need to more than jump in like me and to just take the first person’s opinion you just do some research and find out what’s best for you because I’m a perfect example of someone who just went, ‘Yeah ok’. And did the first thing the first doctor said to me but in hindsight I wish I’d done a bit more research on each thing.

Stefanie's GP sent her a letter informing her of the possible link between Depo Provera and osteoporosis, but another doctor 'dumbed down' the report's findings.

Do you have any health concerns about injections or the implant or? Because you talk about hormones and chemicals?

 

I didn’t until I read the report about osteoporosis and it specifically said “people that were”. There have been. I mean there’s no real proof but it said that people who should be most wary are anyone on it for a long period of time and anyone who is given it before the age of 18. So of course I come into both of those categories. So that did make me nervous. And I spoke to one of the doctors about it and she said, “Oh it will be fine. Just drink more milk. You’ll be fine.” I don’t know how scientific that is but it did make me feel a little bit nervous about.

 

Do you think that you have been given enough information?

 

I wasn’t regarding osteoporosis. I don’t know if that was a study that came out afterwards. It’s more than likely. So I hope that they do tell more people about it. I would like to have known about it before. And regards to side effects I was given reading material. I don’t necessarily think that’s a good idea. I don’t know about. I don’t want to generalise but I know when I was 16, 17 I didn’t really read anything I was given flyer-wise because you can be swamped in that kind of stuff.

 

So what do you think is going to be the best way to give a young teenage this type of information? What would have worked for you?

 

Just I think verbally when I was younger would have worked. Nowadays I like to find out for myself on the Internet but I can’t imagine many people and not everyone would have. People like to just be spoon fed and not really think about it. I know that’s what I was like. But flyers for me just didn’t. They just went straight in the bin and I never really properly read them.

 

Ok and did you find out this information about the possible kind of relationship between long term use of the injection and osteoporosis or it was raised by a doctor?

 

Actually now you mention it I think because that’s a good point I don’t know why I would have suddenly found this out. And I think that it might be because my doctor’s sent me a letter. I think they went through their records of everyone who had been on the injection and notified them, if I think that’s what happened. And of course I got the letter and I was I don’t know if they had to do it to everyone who they gave the injection to but I imagine then if people were at clinics where they might not have received that kind of information. I don’t know how it works but my doctor would have had my proper address on the records so they sent me a letter.

 

And following that you went to try and get more information from a GP.

 

Uh huh.

 

So how did you feel about the fact that she said that you would be ok, drink more milk?

 

It was what I wanted to hear. She said that, “It’s not proven. I’ll be fine.” And she dumbed it down. So at the time I felt better because I thought, ‘Well she’s a doctor she knows’. But now I probably would have liked to have been given more information so I could have decided then because I carried on with the injection for a few years after that. So it maybe would have been better if she had been a little bit more up front which she obviously personally didn’t think much of the research itself. But inflicting your personal opinion on someone as influential as I was probably is not the best thing to do.

Stefanie wasn't invited by her GP surgery to have a Chlamydia test so, she asked for it. She also wanted to be tested for HPV virus as she had heard it can cause cervical cancer.

The practice I used to go to from where I lived down in [region] they used to be quite, not very warm and friendly. They used to be very ‘in and out’ so they would measure my blood pressure, get me on the scales, do it then go. They weren’t very quick to give advice either. You had to ask questions. They would never be first to give you the advice and they never offered me any kind of testing. You had to ask for it yourself.

STI?

 

uh huh

 

Ok.

 

Because there’s I believe isn’t there at the moment anyone under a certain age is asked, should be asked, but I never was.

 

Ok. So did you ask for that?

 

Yes, yeah.

 

Ok how old were you when you asked?

 

By then I was 23.

 

Ok so they didn’t offer it before that?

 

No, never.

 

You went and asked for STI testing. And do you remember which test you had? Did you have a Chlamydia test?

 

Yes, yes I went for a Chlamydia test. No particular reasons, other than my friends were doing it and we sort of had a pact if they tried it I would. We had such horror stories of people who had no symptoms.

 

Ok so you had had sex without using a condom?

 

Yes, yeah.

 

So that was the main sort of reason?

 

Yeah. I’d only myself had, even now only had a couple of partners so it was never a concern for me at all. But there’s always that ‘What if’ niggle so it’s. I would recommend anyone to do it. It’s not scary and it’s for the day and age we live in it’s important.

 

Can you tell me how many times have you had the test done?

 

Just the once.

 

Just the once, ok.

 

But that was last year. I’m still with the same partner now.

 

Ok was your partner tested also?

 

Yes, yes he was.

 

Ok. So and it was done here or where you used to live?

 

I actually went back to my old practice, yeah down in [region].

 

So you just had the Chlamydia?

 

Yes that’s right because this was actually at my doctor’s. I also asked them about, while I was there, I’d heard a lot of the radio adverts talking about people under a certain age should get checked now for cervical cancer [HPV virus which can cause cervical cancer]. And I asked them about it and she said, ‘Oh you’re sort of over that age group now so don’t worry too much.’ And I thought that was a bit odd because I’m someone willing to just check it out and then she sort of…

 

So they didn’t give it to you?

 

No [laugh]. I think they were probably busy that day or something. But they didn’t encourage it at all. They said that I wasn’t the market they were targeting at the moment to do it.

Stefanie would like to hear personal experiences of women who are using the coil.

 

I was advised by someone I know to try the coil but I’m. I haven’t been told a lot about it and even when I have it tends to be from people who know it from a medical journal and not from personal experience. I would like to meet more people who could give me genuine, firsthand experience of what it is like because it sounds slightly horrifying but it sounds also like the most natural form of contraception without pumping your body full of chemicals. So I really want to weigh up other people’s opinions about it and I don’t tend to. It’s not just something you can just ask everyone you know while over the water cooler.

 

So now you are thinking about the coil but you would like more information about it.

 

But I think no amount of reading text or flyers is going to ease my opinion on it. I really would like to see maybe an interview like this with people who can explain what it was like. The procedure itself sounds a little bit terrifying, well not terrifying but uncomfortable. And then what is it like once it’s there? How long can you have it for? Those kind of things and how long and yeah what their body was like afterwards. Did they go, have normal periods? I think if I could see interviews like that from people it would be very useful.

 

Or for a doctor answering those questions?

 

I don’t know. I think because of the experiences I’ve had of doctors I do take a lot of it with a pinch of salt. I’m not saying that they are always wrong, of course they are not, but it’s not quite the same as meeting people who have had the real experience of it. And of course their experience could be entirely different from what yours would be but I’d feel more comfortable if I could talk to people who have got it because a lot of doctors may not have even tried it. So they couldn’t give a firsthand experience of what it’s like.

 

Stefanie describes Brooks website as non-patronising and non-threatening, specially written for young people.

I think I personally digest it better if I go and find out the information for myself.

 

And which websites do you tend to look at?

 

I just write into Google and look at anything that comes up which obviously then you go on Yahoo questions and have some 12-year-old tell you what they think but certain things like the Brooks website that I’ve been on a couple of times and I found that quite useful.

 

Sometimes there’s a, I believe it’s an American medical website that is like a diagnosis website. I think it’s called MedGP or something. I’m not entirely sure but it’s really easy to find with Google and you can go on it and write in symptoms and I find that quite a good medical website. Although I do take everything I read with a pinch of salt because I don’t want to start self-diagnosing myself for dreadful conditions.

 

And when you say that you found the Brook’s one a good one what do you think is good about it?

 

It’s not patronising. It’s, friendly. The way it is written is non-threatening and I think personally looking at it from someone who likes to look at it from a different perspective I think for younger people because when I go to Brook I feel like the oldest person there. Everyone else in the clinic is younger than me. I think people my age tend to have got a doctor sorted and go to a doctor but everyone else seems to be significantly younger. So I think it’s important that the website is written in a non-threatening way.

Stefanie indicates that hers and her boyfriend's decision to test resulted from the awareness brought about by media campaigns about the health risks of STI's.

When you were tested for Chlamydia you asked him [partner] to go to the clinic with you or?

 

No we both went separately actually but he was one of the people I knew that was going and I just thought it was only fair that I do as well.

 

You were together at that time?

 

But yes, yeah. It, it was for no particular reason. It was just because we are both really confident but television is making everyone a bit more aware about it and. Because we knew we wanted to spend the rest of our lives together we thought, “Why not start out with a clean slate”, really. So we know for sure and just made us feel 100% certain that we were fine.

 

It was at university and I think someone put up a sign and a member of the group started talking about it and some people expressed their concerns about doing it and others were saying “Well who had been?”, talked about their experiences and we kind of rallied together and agreed to do it together which I think makes it easier. And I think the adverts, I think that’s the key thing. They are breaking the taboo. They are making people talk about it especially the campaign on the television about, I think, people talking in those clouds. A lot of television programmes now like I mentioned the Channel 4 programme, they went into a nightclub and tested 5 people at random, 5 guys, 5 girls and said. They all thought they would be clean and a few of them weren’t. And it does make you go, ‘Wow’. So I think people just need to talk about it more. And not be afraid.