When Julian Okonta witnessed her friend, Felicia Awolusi, face an early pregnancy, she felt compelled to launch a campaign educating young Nigerians about sexual and reproductive health. However, she quickly discovered a pervasive problem: countless women who wished to avoid pregnancy were too terrified of contraception to use it, often fearing abandonment by their partners.
Personal Stories of Pain and Fear
Aisha Adeboye is one such woman who has decided against modern family planning. She initially considered the three-month contraceptive injection but was swayed by alarming stories from other women. "I have heard a lot of terrible things about it," Aisha confessed. "They say it makes you add weight, causes hormonal imbalance, makes your menstruation irregular, and makes your tummy big."
For Aisha, the issue extends beyond physical side effects. She highlights the lonely burden Nigerian women carry, often worrying about childbirth and contraception without support from their husbands. "It's disheartening. They don't want you to get pregnant, yet they want sex without as little as emotional support," she lamented. Her fear led her and her husband to resort to the withdrawal method, a less reliable form of contraception.
The ordeal of Ibidun Adewale, a mother of two expecting her third child, paints a grimmer picture. After getting a family planning implant, she experienced non-stop heavy bleeding. "My body became a rain of blood," she described. "Headaches became a daily routine and over all body discomfort threatened my very existence." Despite her doctor's assurances that her hormones would adjust, her condition worsened over six months, forcing her to remove the implant. She became pregnant just one month after its removal.
Anita Osarieme's story reflects the consequences of this fear. Scared by negative narratives about side effects and lacking guidance, she now has five children she and her husband struggle to provide for on a low income. "We live in a below standard single room with five children we can't cater for," she said, noting that her husband stays away from home to escape the responsibility.
The Science Behind the Side Effects
According to family planning consultant Jocelyne Nwalozie, the root of these adverse reactions lies in the hormones found in most modern contraceptives. The presence of estrogen and progesterone is the primary cause, interacting with the body in ways that lead to a range of side effects.
Nwalozie explained that progesterone can increase appetite and cause fluid retention, leading to weight gain. These hormonal changes can also disrupt the function of mood-regulating hormones like dopamine and serotonin, causing emotional instability. Furthermore, hormonal contraceptives can cause thinning of the uterine lining, resulting in spotting or irregular bleeding.
The severity of these effects is not uniform; it varies drastically from woman to woman. Nwalozie emphasized that genetic factors, pre-existing medical conditions, and a woman's unique physiological makeup all play a critical role in determining her tolerance for a specific contraceptive method.
The Critical Need for Professional Guidance
Nurse Julian Adegboyega identified excessive bleeding as one of the most common side effects reported, alongside weight fluctuations and elevated blood pressure. She stressed that a thorough medical assessment is non-negotiable before administering any method.
This initial screening should include:
- Weight and blood pressure monitoring
- Pregnancy testing
- Breast and pelvic examinations
- Screening for sexually transmitted infections (STIs)
- Blood sugar testing
Nwalozie added that providers must gather comprehensive personal and medical history, including the number of children, breastfeeding status, and history of conditions like diabetes, hypertension, or migraines. Adegboyega also identified a major challenge: a lack of full disclosure from patients. When women withhold information about past abortions or irregular menstrual cycles, it becomes nearly impossible for healthcare providers to recommend the safest, most effective method.
The World Health Organisation (WHO) underscores the global importance of this issue. As of 2021, 164 million women worldwide have an unmet need for contraception. Achieving universal access is vital for fulfilling the 2030 Agenda for Sustainable Development and upholding the fundamental human right to decide freely on the number and spacing of children.
For Nigerian women like Ibidun Adewale, the path forward is one of caution. "Nothing will make me administer any family planning method that sets my entire body system in a state of discomfort again," she vowed, "unless there is 99 per cent certainty of a suitable method." Her statement echoes the urgent need for personalized medical counseling and robust support systems to help women navigate the complex landscape of family planning safely and confidently.
