More than half of young Danish girls use oral contraceptives, better known as birth control pills, in order to prevent pregnancy or regulate their periods. Experts discuss different opinions why girls begin consuming the pills at such a young age in Denmark.
By Demi Korban
When 15-year-old Christine Elbæk Hansen became intimate with her first boyfriend, the first thing they thought of as a couple was to buy condoms and a pregnancy test, until her mom discovered about the relationship and took her to a general practitioner, where she was prescribed birth control pills.
“Well, it is kind of a funny story. I went out with my boyfriend to a pharmacy when we started having sex together. We bought condoms and a pregnancy test, because I thought you know what, shit happens, and it would be nice to have it in hand,” recalls Christine, who is now 25-years-old studying at Aarhus University.
“My sister went and sneaked around in my room, when she opened the closet the pregnancy test fell on the floor, but she didn’t see it. Then, when my mom came in for laundry and she came to me running like: Oh my god, are you pregnant?” she continues.
According to a recent study released by the Danish Medical Journal, around 85 percent of 20-year-old female Danes have used birth control pills, and 140 mill daily dosages have been sold in the market on average yearly for the last ten years.
Reasons why Danish youth consume birth control pills differ
Birth control pills are very popular among Danish youth because it gives them the freedom of sexual activity without pregnancy, which is something they are taught to do at a very early stage, says Charlotte Wilken-Jensen, leader of Sex og Samfund’s sexual health clinic, a Danish non-governmental organization who are watchdogs for sexual rights and family planning.
Danish girls begin using birth control pills in their mid-teens because they become sexually active earlier than teenagers from other countries. Based on a 2014 study in Ugeskrift for Laeger, on average, Danes have their first sexual relationship at the age of 16, which has been the constant age since the 1960’s.
Christine shares her own experience with birth control pills.
However, the pill is also prescribed for strong cramps and heavy bleeding and other related menstrual pains, says Ellen Christine Leth Løkkegaard, clinical research associate professor at University of Copenhagen, who also wrote a study about how Danes start birth control pills early.Ellen’s personal belief is that the pill should only be given to those who are sexually active rather than ones experiencing severe pain from their periods.
“My personal point of view is that I do not encourage the use of birth control pills unless they need it for sexual protection. If they have the condition where they perhaps have menstrual pain, I would suggest a pain killer or something similar,” she says.
Contrary to that, Charlotte explains that some girls are in need of the pill before they begin being sexual active because of a medical issue called endometriosis, which is when the tissue that normally lines the uterus grows outside the uterus causing severe abdominal pain that is reduced with the help of the pill.
“Years before they start having sex they are sick when they are on their periods. If you don’t treat them when they are young, they will have the risk of having severe problems later on with infertility. Those girls need to take the pill even though they are not in need of the pill for protected sex. For that, we do encourage its use,” she says.
Charlotte talks about birth control pills.
Birth control pills are also efficient because girls get the chance to regulate their periods based on their need and ability to endure pain, says Evin Odison, pharmacist at Vejle Løve Apotek.
“A lot of girls can control their periods. I think for a lot of girls it is important that can control their periods, to say okay now I have it and in 21 days I will get it again. So, it is like a control issue,” she says.
Christine, who has been a regular consumer of birth control pills since the age of 15, believes that a girl should only take birth control if she is ready for it and is leading an active sexual life.
“I think girls should start when they are ready for it. It is an adult decision in someway. Some people take it to reduce cramps. If you are not ready to have sex you should not be on them,” she says.
The pill as part of school education
Even though sexual education is part of the academic curriculum for students in the 1st grade through the 10th grade, other organizations are also involved in exposing the youth to contraceptive options.
Kvindemuseet, which is a women’s museum based in Aarhus that displays the development of gender equality in Danish culture, as well as Sex og Samfund are of those organizations involved in teaching youth about the importance of birth control.
“Women should be taught about it at an early stage because it is important that they take care of not being pregnant when they don’t want to. However, they should remain aware about the effects of introducing unnatural chemicals to their bodies,” says Merete Ipsen, the director of Kvindemuseet.
In Kvindemuseet lies a room with several round tables, where students between the ages of 14 and 17 discuss the development of contraception over the years. The students rely on a large wooden case that portrays the different methods, with the pill being one of them.
Charlotte, the lead sexual doctor at Sex og Samfund explains that they have two representatives, whom she personally teaches about contraception and related topics. Those representatives teach young students in schools as part of a joint collaboration between the school and the organization.
Some pill manufacturers, on the other hand, are banned to market their products directly to the public, explains Hans-Jacob Randskov, public affairs and policy senior manager at Pfizer Denmark and Iceland, which is a global pharmaceutical corporation that produce birth control pills.
Instead, they rely on digital media accounts, such as Facebook and public webpages to reach out to the youngsters.
“Pfizer reaches out to young women and their mothers with general, non-branded and non-product specific awareness information about hormones and birth control in general,” he says.
Second generation pill proven safest
There are four generations of birth control pills available in the market. Recent studies show that the latest generation of birth control pills has the highest risk of blood clots, which are lumps resulting from the hardening of blood from liquid to solid.
The risk of blood clotting decreases when using the second generation pill rather than the fourth generation pill, explains Hans from Pfizer.
Despite the high rate of consumption, the use of birth control pills has decreased by around 10 percent during the last year due to the links between the latest generation of pills and blood clots, says Ellen, researcher from University of Copenhagen.
With that in mind, general practitioners in Denmark went back to prescribing the second and first generation pills, which have the lowest risk of blood clotting.
Hans says that the the second generation pill has the lowest level of a hormone called oestradiol being one reason why they are safer in terms of blood clots. He adds that the birth control pills are more than 99 percent safe, if taken as prescribed.
In Denmark, people must be 15-year-olds in order to pick up a medicine without parental consent. However, Pfizer recommends based on testing that their birth control pills are safest if consumed between the ages of 18 and 35.
Ellen agrees because it is always best to wait at least two years after menarche, which is the onset of the menstrual cycle, in order to start taking birth control pills since the girl is still at her growing period before that.
“I am afraid it will cost them a few centimeters from their final height if they take oral contraceptives at menarche. So, one rule I would say is waiting two years after menarche and also I would like them to actually need the pills,” she says.
It is also important to look into the patient’s family history with blood clots when prescribing birth control pills to avoid increasing the risk of a blood clot, says Charlotte, Sex og Samfund’s lead sexual doctor.
“It is very important to give the pill to the right person, one who is completely healthy and does not have a family history of blood clotting. It is also very important to inform the ones who take the pill that if they have symptoms of a blood clot they must inform the health system about it and mention that they take the pill,” Charlotte says.
“We know from the studies that have been made that sometimes it is misinterpreted when they are undergoing the symptoms and that is when it is dangerous.”
‘Cornerstone for gender equality’
Besides the fact that the pill reduces unwanted pregnancies to the minimum, it has also been a cornerstone for gender equality in Denmark and around the globe, says Merete Ipsen, the director of Kvindemuseet.
“The pill has allowed women to have a choice in pregnancy and raising children. Before the pill, women had more pregnancies and children than they desired, which gave her an obligation towards raising children because sex was something the man would decide,” says Merete.
She adds that in previous generations Danish people of all sexes would work together even if they were sick, bleeding, or had a headache, however, she believes the pill has been a pillar for gender equality.
Ipsen explains that the pill was first introduced in 1966 and with the rise of the women’s movement in the early 70’s it was very common for women to start taking the pill, however, it wasn’t until the late ‘90’s where it has become common for very young women to use the pill as well.
Today, she thinks a different movement should rise where men also take part in the responsibility of conception, so that gender equality can be strengthened.
Merete Ipsen, Kvindemuseet director, explains what birth control pills have meant to women in Denmark.
“We need a movement today where men also take responsibility of conception,” says Merete.