oral contraceptives

Doctors Say the Darndest Things About Birth Control

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A while back, a friend of mine shared a story on Facebook about a doctor’s nonchalant response to side effects experienced by a patient on birth control. I commented that this was one of my least favorite among the common phrases doctors use to gaslight women.

That friend was Sara Harris, who is doing amazing work getting the word out about Fertility Awareness Methods and helping women with hormone issues in Australia with her podcast, Follow Your Flow. Sara knew I was wrapping up work on a new, expanded audio version of my book and recommended I visit her podcast again to promote the audiobook and present my ‘Top 10 Least Favorite Things Doctors Say About Birth Control.’ You can listen to the resulting podcast here.

Lack of Respect

Obviously, I took her up on the offer, burning a lot of energy to get my Top 10 in the proper order – only to change that order and change it again the more I contemplated each phrase. Ultimately, I felt like I could have just as easily said they were in no particular order because each dismissive phrase poses its own set of disturbing problems.

For the purpose of this article, I want to focus on three of these statements, which are particularly egregious in their lack of respect for the potent drugs delivered by hormonal birth control and the detrimental impact they have on women’s health.

And so, here are those three statements… this time, in no particular order.

Localized Hormones

“This birth control option is safer because the hormones are localized.”

Doctors tend to offer this falsehood when speaking about either NuvaRing or the hormonal IUD. It is frequently used to sell a young woman on using the device, but it’s also used later to dismiss questions she may have about side effects she develops after insertion.

I have trouble believing that a medical doctor actually believes that these hormones camp out in the uterus and just manage fertility. Hormones are systemic. By their very nature, they travel throughout the body attaching to hormone receptors that reside on every cell in our bodies.

Now, here’s the kicker – not only are these drugs not localized, but they have the potential to be even more dangerous than hormones that are taken by mouth. Oral contraceptives (as with any drug taken orally) are processed through the digestive system in what is known as first-pass metabolism. This process reduces the concentration of active drug prior to being introduced into the blood stream.

Consequently, drugs distributed via the uterus bypass this first-pass metabolism thereby reaching the bloodstream more quickly and in a more potent state.

It shouldn’t be surprising then that a recent Danish study found that women on NuvaRing were six times more likely to develop a deep vein thrombosis than women not taking birth control, and twice as likely as women taking a combination pill.

Psychotropic Candy

“Don’t worry. I’ll just prescribe an antidepressant to go with your birth control.”

Many doctors seem to think antidepressants can be used to accommodate just about any symptom manifested as a result of birth control. In my book, In the Name of The Pill, I shared the story of a young woman with lupus.

After quitting hormonal birth control, her lupus symptoms became surprisingly manageable. This continued for a few years, until she decided to try a different formulation of birth control. Shortly after starting The Pill again, her lupus symptoms came roaring back. But, when she told her doctor about it, he didn’t think the birth control had anything to do with her flare-ups.

He advised her to keep taking it and prescribed her an antidepressant to ‘help her rest better.’

I believe doctors who pull stunts like this have lost any sense of respect for the potency of the drugs they are doling out. This goes for any drug – not just birth control. As one of the doctors Barbara Seaman quoted in her landmark book, A Doctors’ Case Against the Pill, warned, “It needs to be emphasized that if you give a patient one drug and counteract it with another, there is a rising curve of adverse reactions.”

In my opinion, this warning should be doubled where birth control is concerned because the powerful drug is essentially being used to treat pregnancy rather than some life-threatening disease. As Mayo-trained, Dr. Philip Ball put it at the Nelson Pill Hearings, “I believe that we physicians are so used to administering very potent medications to very serious disease problems, we have not really yet learned, it is a totally different circumstance to administer powerful but nonessential drugs chronically to healthy young women.”

You can read more about specific concerns related to the mixture of psychotropic drugs and hormonal birth control here.

Suddenly Supplements

The third comment deals exclusively with the Depo injection and needs a little setup. The FDA requires a black box warning on this drug’s information pamphlet. A warning in big, bold letters accentuated by a thick, black frame states:

“WARNING: LOSS OF BONE MINERAL DENSITY”

The warning goes on to explain that your bone loss will be greater the longer you take the product and these changes may be irreversible. It reinforces these concerns by stating that Depo should not be used as a long-term birth control solution, even capping its recommended use at no more than two years.

That seems pretty clear and absolute, but many women who have asked their doctors about this warning have been told:

“Just take a calcium supplement, and you’ll be fine.”

Mind you, the FDA warning says nothing about taking a supplement to offset the affects. In fact, it doesn’t suggest there are any measures you could take to avoid the potential consequences.

The FDA is a slow-moving, bureaucratic government agency. It takes a lot of evidence to overcome the inertia associated with issuing such a dramatic black box warning. For a doctor to ignore or deny such a warning and suggest the solution is as easy as taking a calcium supplement is borderline criminal.

Health as a Business

If your doctor ever uses any of these three lines, you should seriously question his/her motivation. Do they care about your health or do they see your healthcare as a business?

One of the things I frequently tell women is to trust your questions more than the answers. If you mention a side effect that concerns you, and your doctor seems more interested in convincing you The Pill had nothing to do with it, don’t assume you’re crazy or you’re the only one experiencing this. Your body is sending you this warning sign for a reason. Keep questioning.

I once had an Ob/Gyn tell me that it’s difficult to get anyone from her specialty to say anything bad about hormonal contraceptives because it represents about a third of their business.

However, if you are a medical professional who recognizes that birth control is much more dangerous than women are being led to believe, be proactive in sharing that information, even if you aren’t an Ob/Gyn.

Women need to hear it. Many feel isolated. They’re afraid to discuss their side effects because they think they’re the only ones having a bad experience. Or worse, they wonder if they may be going crazy.

An eye surgeon recently reached out to me and shared what’s been happening at her practice after she read my book. She said she always takes a complete medical history, part of which includes the patient’s use of hormonal contraceptives. Lately, even though she doesn’t deal directly with menstrual issues, when a woman reports certain ‘mysterious, undiagnosable symptoms,’ this doctor has started recommending they stop taking their birth control. She said a few patients have already contacted the office to thank her because their symptoms have improved dramatically.

I hope more physicians will hop on board and fearlessly tell women about the myriad side effects of birth control. We still have a ways to go, but maybe someday I will be able to compile a list of my Top 10 Favorite Things Doctors Say About Birth Control.

#1
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This article was published originally on December 13, 2021. 

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Oral Contraceptives, Epigenetics, and Autism

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Oral Contraceptives and Autism

Over the last several months, I have published a series of articles exploring the potential connection between the use of oral contraceptives and the increased prevalence of Autism Spectrum Disorder (here, here, here, here, and here). It is my hypothesis that the synthetic hormones in oral contraceptives, which were created to imitate natural human hormones and disrupt endocrine function to prevent pregnancy, may be causing harmful neurodevelopmental effects in the offspring of women who use them [1].

The mechanisms by which oral contraceptives instigate neurodevelopmental changes is slowly emerging. It appears that in addition to preventing pregnancy, synthetic hormones like ethinylestradiol, used in most birth control formulations, initiate epigenetic alterations in the oocytes (eggs) causing persistent changes in expression of the estrogen receptor beta gene (ERβ). When those eggs become fertilized and conception ensues, the changes in the estrogen receptor gene impact the expression of autism and other neurodevelopmental disorders.

Ethinylestradiol is an Endocrine Disruptor

Here is how the ethinylestradiol used in oral contraceptives adversely modifies the condition of the oocyte. Bear with me, this is a bit complicated, but if you are woman who uses or is contemplating using oral contraceptives, this information is important to understand.

Ethinylestradiol is a known endocrine disruptor. Anything that disrupts endogenous hormones can be considered an endocrine disruptor. Evidence is emerging that ethinylestradiol may trigger what is called DNA methylation of the estrogen receptor gene. This then causes decreased messenger RNA resulting in impaired brain estrogen signaling in offspring [2]. Let’s think more deeply about this.

Methylation means that, by way of a chemical process, a gene is turned on (hypomethylation) or turned off (methylation) by an enzyme or protein. Researchers believe that methylation is one of a number of mechanisms by which environmental interactions influence genetic activity. In this case, ethinylestradiol silences or turns off some important processes that are associated with estrogen signaling, namely receptor activity.

Methylation and other epigenetic reactions influence health and disease processes across generations. This is called transgenerational transmission. So, I suspect that the deleterious effects of ethinylestradiol on the estrogen receptor gene are transgenerational. This is possible because the estrogen receptor gene may be an imprinted gene. Imprinting is a dynamic epigenetic phenomenon by which certain genes are expressed in a parent-of-origin manner. If the allele, an alternative form of the same gene, inherited from the father is imprinted, it is thereby silenced, and only the allele from the mother is expressed. If the allele from the mother is imprinted, then only the allele from the father is expressed.

If the estrogen receptor gene is an imprinted gene and silenced, then the oral contraceptive-induced methylation marks could be protected from global demethylation. Global demethylation is a protective process which is believed to occur throughout somatic cell differentiation and happen only twice during development, in primordial germ cells and in the pre-implantation embryo. If the methylation marks are protected from global demethylation, they will be preserved through fertilization and beyond to progeny generations.

To sum this up, durable changes to the function of the cells would be passed on by the aberrant methylation that piggybacks on the normal imprinting mechanism that protects epigenetic markings from reversal or demethylation. Ethinylestradiol, while successful at preventing pregnancy, may be damaging stored oocytes in such a manner that the offspring that emerge from those oocytes carry that same damage.

In addition, deleterious effects of exposure to oral contraception could perpetuate or even increase over generations as a result of both transgenerational transmission of the altered epigenetic programming and the continued exposure across generations. This has the potential to impart disease sensitivity at a later point in time [3,4,5]. While this concept, in the case of oral contraceptive use, is speculative, transgenerational imprinting was first studied in human beings in cases of nutritional factors [6,7,8]. In addition to nutritional factors, animal studies have shown that estrogens, androgens, progestagens, or similar receptor-level acting molecules, such as endocrine disruptors, can have harmful transgenerational effects [4,9,10].

How Impaired Estrogen Receptors and Estradiol Regulation Affects Brain Function

Estrogen receptors affect the regulation of endogenous estradiol concentrations. Estradiol is the primary estrogen our body synthesizes to regulate a variety of reproductive and non-reproductive functions. Estrogen receptors are located all over the body, in the heart, lungs, fat cells, and in the brain.

Maintaining appropriate estradiol concentrations in the brain is critical for mood, memory and a number of other cognitive functions. Estradiol is critically important because it directly influences brain function through the estrogen receptors located on neurons in many areas of the brain. Estradiol has direct protective effects on neurons and helps with the maintenance and survival of neurons. Endogenous estrogens, like estradiol, stimulate creation of nerve growth and viability, repair of impaired neurons, and influence dendritic branching. Estradiol also increases the concentration of neurotransmitters such as serotonin, dopamine, and norepinephrine and affects their release, reuptake, and enzymatic inactivation. In addition, estradiol increases the number of receptors for these neurotransmitters.

Synthetic estrogens, like ethinylestradiol used in many birth control formulations, may adversely affect the equilibrium of the endogenous estrogens like estradiol by disrupting sensitive hormonal pathways and impairing estrogen receptor expression. When the estrogen receptors become impaired, not only are hormone concentrations likely affected, but those functions that this hormone and receptor are responsible for regulating, are altered as well; functions like mood, memory and cognition.

Estrogen Receptors, Mood, and Cognition

Impaired estrogen receptor expression has been associated with altered emotional responses, depression, mood disorders, cognitive dysfunction, brain degeneration, and many other endocrine-related diseases [11-16]. In addition to confirmation that estrogen receptors are a factor in emotional responses [11], there is compelling evidence for estradiol’s involvement in the regulation of mood and cognitive functions [12,13,14]. Because the hippocampus, entorhinal cortex, and thalamus seem to be estrogen receptor beta (ERβ)-dominant areas, this suggests a function for ERβ in cognition, non-emotional memory, and motor functions [13,14]. Children with autism have notable difficulties in all of these areas.

Research also shows that estrogen is able to regulate the serotonin (5-HT) system, which has been associated with affective disorders [13,14]. Furthermore, recent studies using estrogen receptor knockout mice have assisted in defining the function of estrogen receptors in brain degeneration [15]. In vivo and in vitro studies also show that estrogen receptors are mechanistically involved in endocrine-related diseases [16]. Given that ERβ is the main estrogen receptor expressed in the cerebral cortex, hippocampus, and cerebellum [17], it is not difficult to imagine that epigenetic mechanisms cause persistent changes in gene expression of estrogen receptor beta (ERβ) that result in neurodevelopmental disorders like autism.

Interestingly, a recent study discovered a significant association of the lowered levels of the ERβ gene with scores on the Autism Spectrum Quotient and the Empathy Quotient in people with autism [18].

Evidence of Dysregulation of Estrogen Receptor Beta

Motivation for this epigenetic hypothesis comes from a recent study by Pillai et al., Dysregulation of Estrogen Receptor beta (ERbeta), Aromatase (CYP19A1) and ER Co-activators in the middle frontal gyrus of autism spectrum disorder subjects. This study examined the brain tissue of people that had ASD’s. The scientists found that the ASD brain tissue had far lower levels of a key estrogen receptor and other estrogen-related proteins [19]. The scientists measured the expression of proteins involved with estrogen signally pathways in brain tissue measuring levels of estrogen receptor beta and aromatase, an enzyme that changes testosterone to estradiol. Pillai et al. found 35 percent less ERβ. In addition, they discovered much less messenger RNA of estrogen co-regulators SRC1, CBP and P/CAF at 34 percent, 77 percent and 52 percent respectively [19]. Their results provide compelling evidence of the dysregulation of ERβ and co-regulators in the brain of subjects with ASD. Their data suggest that the synchronized regulation of ER signaling molecules has a significant function in ER signaling in the brain and that this coordinated network may be compromised in people with ASD.

Growing research supports the hypothesis that epigenetic mechanisms are causing persistent changes in gene expression of estrogen receptor beta that result in autism in offspring of mothers who use oral contraceptives. What is perhaps most troubling, is that it may be that the adverse effects of DNA methylation of the estrogen receptor gene are transgenerational.

Final Thoughts

We are just beginning to understand how endocrine disruptors can modify the development of specific tissues that lead to increased vulnerability to diseases and disorders. And, we are just beginning to appreciate the critical roles that hormones play in neurodevelopment, including neuroendocrine circuits that control physiology and sex-specific behavior that could result in behavioral and psychiatric conditions. As women, we have a crucial decision to make about which kind of birth control we use. Because there are inherent risks in all medications that we take, it is important that we fully understand all of the risks of the drugs we choose to use. Although this research is in its early stages, there is a growing body of evidence that ethinylestradiol initiates epigenetic mechanisms that cause persistent changes in gene expression of the estrogen receptors that contribute to the risk of autism in offspring.

References

  1. Strifert, K (2015) An epigenetic basis for autism spectrum disorder risk and oral contraceptive use. Med Hypotheses. 2015 Sep 6. pii: S0306-9877(15)00323-0. doi: 10.1016/j.mehy.2015.09.001
  2. Strifert, K (2014) The link between oral contraceptive use and prevalence in autism spectrum disorder. Medical Hypotheses December 2014 Volume 83, Issue 6, Pages 718–725
  3. Skinner M (2008) Epigenetic programming of the germ line: effects of endocrine disruptors on the development of transgenerational disease. Reproductive BioMedicine Online Vol 16 No 1. 23-25.
  4. Skinner M (2014) Endocrine disruptor induction of epigenetic transgenerational inheritance of disease. Molecular and Cellular Endocrinology Jul 31. pii: S0303-7207(14)00223-8. doi: 10.1016/j.mce.2014.07.019.
  5. Vaiserman A (2014) Early-life Exposure to Endocrine Disrupting Chemicals and Later-life Health Outcomes: An Epigenetic Bridge? Aging and Disease Jan 28;5(6):419-29. doi: 10.14336/AD.2014.0500419.
  6. Kaati G, Bygren LO, Edvinsson S (2002) Cardiovascular and diabetes mortality determined by nutrition during parents’ and grandparents’ slow growth period. Eur J Hum Genet. 2002 Nov;10(11):682-8.
  7. Pembrey ME (2002) Time to take epigenetic inheritance seriously. Eur J Hum Genet. 2002 Nov;10(11):669-71.
  8. Pembrey ME, Bygren LO, Kaati G, Edvinsson S, Northstone K, et.al (2006) Sex-specific, male-line transgenerational responses in humans. Eur J Hum Genet. 2006 Feb;14(2):159-66.
  9. Csoka, A B, Szyf, M (2009) Epigenetic side-effects of common pharmaceuticals: A potential new field in medicine and pharmacology (Article). Medical Hypotheses Vol. 73, Issue 5, 2009, 770-780.
  10. Csaba G (2011)The biological basis and clinical significance of hormonal imprinting, an epigenetic process. Clinical Epigenetics August 2011, Volume 2, Issue 2, pp 187-196.
  11. Amin Z, Canli T, Epperson CN (2005) Effect of estrogen–serotonin interactions on mood and cognition. Behav Cogn Neurosci Rev 2005, 4:43-58.
  12. Berman KF, Schmidt PJ, Rubinow DR, Danaceau MA, Van Horn JD, et. al (1997) Modulation of cognition-specific cortical activity by gonadal steroids: a positron-emission tomography study in women. Proc Natl Acad Sci USA 1997, 94:8836-8841.
  13. Ostlund H, Keller E, Hurd YL (2003) Estrogen receptor gene expression in relation to neuropsychiatric disorders. Ann NY Acad Sci 2003 Dec;1007:54-63.
  14. Osterlund MK, Hurd YL (2001) Estrogen receptors in the human forebrain and the relation to neuropsychiatric disorders. Prog Neurobiol 2001 Jun;64(3):251-67.
  15. Mueller SO, Korach KS (2001) Estrogen receptors and endocrine diseases: lessons from estrogen receptor knockout mice. Curr Opin Pharmacol 2001 Dec;1(6):613-9.
  16. Candelaria NR, Liu K, Lin CY. (2013) Estrogen receptor alpha: molecular mechanisms and emerging insights. J Cell Biochem. Oct;114(10):2203-8. doi: 10.1002/jcb.24584.
  17. Bodo C, Rissman EF (2006) New roles for estrogen receptor beta in behavior and neuroendocrinology. Front Neuroendocrinol 2006, 27(2):217-232.
  18. Chakrabarti B, Dudbridge F, Kent L, Wheelwright S, Hill-Cawthorne G, et.al (2009) Genes related to sex steroids, neural growth, and social-emotional behavior are associated with autistic traits, empathy, and Asperger syndrome. Autism
  19. Crider A, Thakkar R, Ahmed A, Pillai A (2014) Dysregulation of Estrogen Receptor beta (ERbeta), Aromatase (CYP19A1) and ER Co-activators in the middle frontal gyrus of autism spectrum disorder subjects. Molecular Autism 2014, 5: 46. DOI: 10.1186/2040-2392-5-46.

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This article was first published on October 15, 2015. 

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More Side Effects from Birth Control- The Liver and the Gallbladder

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This time of year, the holiday season, can be a time of overindulgence for many of us. And how can we talk about overindulgence without taking a look at the liver? To say the liver is important is an understatement. It is the body’s largest gland and while estimates of the number of functions of the liver vary, many textbooks generally cite around 500. Nearly everything we ingest, from drugs and alcohol to vitamins and nutrients, is metabolized by the liver. The vital role it plays in the functioning of our bodies makes the testimony from the 1970 Nelson Pill Hearings about the effects of oral contraceptives on the liver that much scarier.

Research Presented at the Nelson Pill Hearings

Dr. Victor Wynn was one of the first physicians to testify about the effects of hormonal birth control on the liver.

On page 6341 he states, “if you will take cells out of the liver and examine them under the electromicroscope of women taking oral contraceptive medication, you will find some extraordinary changes.” Of these and other changes caused by the pill, he says: “When I say these changes occur, I mean they occur in everybody, more in some than in others, but no person entirely escapes from the metabolic influence of these compounds. It is merely that some manifest the changes more obviously than others.”

Later to testify was Dr. William Spellacy who was specifically called upon to speak about the metabolic effects on the liver. His testimony about the liver begins, “The biochemical effects of the sex hormones on the liver are legion.” Below is a list of liver functions that, based on the research presented in Dr. Spellacy’s testimony, are altered or impaired (NPH 6427):

  • Lowering of total plasma protein level
  • Decrease in the albumin and gamma globulin and increases in other fractions
  • Tests may be abnormal in women on oral contraceptives without disease being present
  • Estrogen (including that in oral contraceptives) interferes with liver function and varies with dosage
  • Some women taking oral contraceptives have abnormally high blood bilirubin levels
  • 1/3 of women who have jaundice on oral contraceptives will get it when pregnant
  • Discontinuation of oral contraceptives “cures” jaundice

He summed up his thoughts on the liver damage caused by hormonal birth control:

“The immediate effects include the alteration of several of the laboratory tests used in medical diagnoses. Aggravation of existing liver disease, if present, to the point where jaundice may be seen has also been shown. There is no answer to the query of will permanent liver damage result from the use of the oral contraceptives.”

The honorary Chairman of the Population Crisis Committee, a “pro-pill” organization focused on population control added his two cents about the effects of oral contraceptives on the women using them. “While metabolic alterations affecting the liver and other organs do result from use of the pill, there is no evidence at this time that they pose serious hazards to health;” General William Draper, Page 6705.

Of course, we shouldn’t assume that just because a medication causes a “legion” of biochemical effects on the livers of otherwise healthy women that there will be any lasting problems, right?

Research Since the Hearings

“Women more commonly present with acute liver failure, autoimmune hepatitis, benign liver lesions, primary biliary cirrhosis, and toxin-mediated hepatotoxicity,” according to a 2013 article in Gastroenterology and Hepatology.

Like I mentioned in my piece about rheumatoid arthritis, whenever a health issue affects women disproportionately, there is often a connection with hormonal birth control. While this study doesn’t specifically mention that, it does call for further studies assess the role of sex hormones and other behaviors on liver problems in women.

These connections were well-documented at the 1970 Nelson Pill Hearings but the subsequent research gets more confusing.

Timeline of Liver Research

1980: Lancet published an article showing the connection between malignant liver tumors and women using oral contraceptives.

1989: The British Journal of Cancer found “confirmation in this population of the association between oral contraceptives and hepatocellular carcinoma” and “the relative risk was significantly elevated in long-term users [of oral contraceptives].”

1992:This study, the largest to date, adds to the number of investigations demonstrating an increased risk of primary liver cancer with use, particularly long-term use, of oral contraceptives.”

2006:Long-term use of oral contraceptives (OCs) and anabolic androgenic steroids (AASs) can induce both benign (hemangioma, adenoma, and focal nodular hyperplasia [FNH]) and malignant (hepatocellular carcinoma [HCC]) hepatocellular tumors.”

Yet a 2015 meta-analysis concluded that “oral contraceptive use was not positively associated with the risk of liver cancer.” However, the analysis also conceded that “a linear relationship between oral contraceptives use and liver cancer risk was found.” And the authors noted the need for further research into specific formulations of oral contraceptives and the duration of usage.

It makes you wonder how we went from pretty convincing and highly damning connections between oral contraceptives and liver cancer to no positive association at all. Did all the scientists from the 1960s to 2006 get it wrong? Or is something else going on here?

What About the Gallbladder?

Perhaps we can look at the liver’s little buddy, the gallbladder, for some more information. The two are intimately connected in that the liver is constantly making bile and sending it to the gallbladder for storage and dispensation. Like problems with the liver, women are more likely to develop gallstones than men. According to the National Institute of Diabetes and Digestive and Kidney Diseases, “Extra estrogen can increase cholesterol levels in bile and decrease gallbladder contractions, which may cause gallstones to form. Women may have extra estrogen due to pregnancy, hormone replacement therapy, or birth control pills.”

This was proven shortly after the Nelson Pill Hearings. According to the revised edition of The Doctors’ Case Against The Pill by Barbara Seaman:

“The Pill also has serious adverse effects on the gallbladder, and women who take the Pill face an increased risk of someday facing surgery for gallstones. Pill use causes higher levels of cholesterol saturation in the bile, according to a study reported in the New England Journal of Medicine in 1976. This high level of fate in the bile is considered ‘an early chemical stage of gallstone disease,” according to Dr. Donald Small of the Boston University School of Medicine… The risk of gallbladder disease rises with the length of time a woman has been on the Pill… In some studies, Pill users are two and a half times as likely to suffer from gallstones as comparable women.”

A meta-analysis conducted in 1993 found “Oral contraceptive use is associated with a slightly and transiently increased rate of gallbladder disease” and “Considering…the rapidly changing formulas of oral contraceptives, the authors suggest that the safety of new oral contraceptives be evaluated by studying bile saturation and biliary function rather than by waiting for gallbladder disease to develop.”

A much more recent study (2011) found that there was even more risk of gallbladder disease with the newer formulations:

  • Long-term use of an oral contraceptive is associated with an increased risk of gallbladder disease compared with no use
  • There was a small, statistically significant increase in the risk of gallbladder disease associated with the use of desogestrel, drospirenone and norethindrone compared with levonorgestrel
  • Both estrogen and progesterone have been shown to increase the risk of gallstones
  • Estrogen has been shown to increase cholesterol production in the liver, with excess amounts precipitating in bile and leading to the formation of gallstones
  • Progesterone has been shown to decrease gall-bladder motility, which impedes bile flow and leads to gallstone formation

The gallbladder shows us that these hormones are damaging the body.

What Now?

So what do you do when you have a gallbladder that’s not functioning properly? The current practice is to take it out! Of course, removing the gallbladder is not the quick fix many think it is and often leads to other health complications like irritable bowel syndrome, acid reflux, and Sphincter of Oddi Dysfunction.

What about when your liver isn’t functioning properly? That’s not as simple. You can’t just take a liver out. How can the gallbladder, an organ so fundamentally connected to the liver, experience drastic and dangerous changes from hormonal birth control but the liver is supposedly unaffected? Have we researched ourselves out of that problem by declaring that it isn’t a problem? Has there been some spin-doctoring going on when it comes to the liver?

As Dr. Wynn said at the hearings, “There are more than 50 ways in which the metabolic functions of the body are modified, and to say therefore that normal physiological function has been demonstrated in the years of oral contraception is to overlook a very large amount of information.”

I think a very large amount of information has indeed been overlooked.

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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This article was first published December 15, 2016.

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Look Beyond Blood Pressure and Weight

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There was a time when I thought I knew what it meant to be healthy. I was younger then and much thinner too. I swam five hours per day, 5 days per week, lifted weights three times per week and competed on weekends. I loved training, especially the long, grueling, descending interval sets when I could lock into a rhythm and just go, racing the guys in the lanes next to me.

At times I ate really well, but mostly, my diet was crap, filled with diet coke and fast food typical of my generation. I was on birth control pills (high dose, back then), allergy pills (the ones recalled for the risk of heart attack), topped with regular doses of ibuprofen to compensate for training pain and monthly menstrual hell. But I looked good and could compete with the best of them so I thought I was healthy.

Though I knew it wasn’t normal for a teenager or an early 20 something to have high blood pressure and pass out periodically, I neither considered those symptoms as signs of ill-health nor as side-effects of the medications and dietary choices I had made. I had, and still have, a resting heart rate in low the 50 beats per minute – how could someone with such good cardiovascular training be unhealthy? How could someone who was slim and muscular be unhealthy? The blood pressure, the black outs must be a fluke, I reasoned. And the monthly menstrual pain, well, that was normal right? All women writhe on the bathroom floor once a month.

It was years before I began connecting the dots between my symptoms, my diet and the meds. It took even longer for me to question my definitions of health. What does it mean to be healthy? Is it about weight? Many of us tell ourselves that health is all about weight, especially women. I am guilty of this even now. Does weight really correspond to health? Is health something that simple? Certainly, at the extreme ends of weight, there are significant, linear correlations between health and weight, but for the rest of us who fall somewhere in the middle it is not that clear cut.

We know now that body mass index or BMI, the shorthand calculation that most physicians use to determine obesity and by association ill-health, falls short for most athletes, many women, and is especially problematic for older women and men because it doesn’t consider muscle mass. Neither does it consider fitness level nor cardiovascular health, the primary driver for most weight loss campaigns. If weight is not correlated with these other measures of health, one has to wonder if weight is sufficiently sensitive to gauge human health. Perhaps, it is not.

Using myself as an example, I have learned over the years that my blood pressure is sensitive to many medications and toxicants. I cannot take oral contraceptives or I suspect synthetic hormones of any sort. Micronized progesterone landed me in the hospital. Pregnancy also increased my blood pressure exponentially, though it is likely that this was exacerbated by the tocolytics given to slow my contractions and my diet which was low salt but high carbs (sugars).

I cannot take cold medicines (pseudo-ephedrine). Vaccines too spike my blood pressure. Heck, if I am not careful with my coffee intake (I would be better off quitting altogether), that too spikes my blood pressure. As a result, I rarely if ever take any medications now but this was not so for the first 40 some odd years of my life. To say this was a long process, would be an understatement. I, like most of us, tell myself lies about my healthiness. I have always considered myself healthy, even in the face of evidence to the contrary. Now, I know better.

Was my weight ever correlated with my blood pressure? Perhaps, sometimes, but even though my weight has fluctuated dramatically over the last decades, if I dig a little deeper, I can always find another more plausible reason for the increased blood pressure; generally an illness, in itself a stressor, but often one requiring a medication known to increase blood pressure. What is so sad about this realization is that no physician ever made these connections (not even between the oral contraceptives and blood pressure), preferring instead to treat my blood pressure as an entirely discrete entity and with medications that invariably lowered my blood pressure, but also tanked my heart rate into the 30s-40s, something I knew was not safe. And the blood pressure medications working by different mechanisms that didn’t lower my heart rate, well, they had far too many serious side effects. To consider taking any of those meds for the rest of my life was out of the question, at least to me. The cardiologists, on the other hand, had no problem piling on medication after medication.

So when we go back the question of health markers, are weight and blood pressure sufficiently sensitive to detect ill-health? The answer is yes and no. While weight is sometimes associated with high blood pressure, I would suspect both weight and blood pressure are markers of other illnesses or medication reactions. Remove or reduce the burden of those illnesses and blood pressure as well as other indices of heart disease and inflammatory disease processes may diminish as well.

How do we do this? Well, diet and lifestyle contribute immensely. For me, diet has been huge. Using myself as an example again, when I was younger, I was slim and athletic, but had very high blood pressure. My diet was crap back then and I used medications known to exacerbate blood pressure. I am now much heavier (almost obese by BMI standards), still very athletic (currently, CrossFit 4-5 times per week; previously water polo, running, spin) and through diet (non-processed, no sodas, no gluten, only organic vegetables, fruits and proteins) and nutrient supplements, I have maintained ‘normal’ blood pressure, perhaps for the first time in my life. Sure, I’d like to lose 40 pounds or so and maybe at some point my body will begin releasing those fat stores, but it really doesn’t matter. I am healthy and completely medication free, not even ibuprofen for training pain.

Long story short, when we think about health, what it is and what it isn’t, addressing medications, diet and lifestyle (exercise) variables are critical. I always had the exercise component in my favor, but diet and medication use has been problematic. I have recently come to understand, that if we have symptoms ‘requiring’ medications, then we are not healthy, no matter what we tell ourselves and how good we look in those tight or not so tight jeans. In fact, those meds are probably masking and/or exacerbating the real causes of ill-health. Instead of piling on more and more medications, begin disentangling the root of your symptoms, address dietary problems, nutrient insufficiencies and lifestyle variables. I suspect for many of us, with a bit of detective work combined with some lifestyle adjustments, health is within reach. It just may not look like what we have been conditioned to believe it should.

This post was published originally on March 11, 2015. 

Postscript: in the three years since writing this post,  I still maintain a healthy diet and blood pressure, save except for my bout with turmeric induced hypertension (even ‘healthy’ supplements can have some interesting effects on BP). I still workout regularly, though now my sport is powerlifting, where I hold several world records in the old lady divisions. And I weigh more now than I ever have in my life, except during the last week of a pre-eclamptic twin pregnancy where I exploded with water weight. The muscle mass I have gained has moved me ever closer to the BMI obese category. Despite what the scale says, however, I am skinnier than I have been long time and I am certainly fitter and stronger. At 50, I am healthier than I was in my 20s. Diet and lifestyle are critical to health. BMI is not. 

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Falling into the Planned Parenthood Gardasil Snake Pit

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“With 80 percent of clinical trials failing to meet recruitment deadlines in the West, major drug companies are today conducting half or more of their trials outside the major markets, often in countries–like Nigeria–with poor human rights records and weak regulatory infrastructures. Pfizer’s Nigeria trial is unusually sensational and high profile, but its bending of the rules may be more the rule than the exception.” – Sonia Shah, author of The Body Hunters

“It is clear from the evidence presented in this book that the pharmaceutical industry does a biased job of disseminating evidence – to be surprised by this would be absurd – whether it is through advertising, drug reps, ghostwriting, hiding data, bribing people, or running educational programmes for doctors.” ― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

The entire mess of questioning one vaccination – HPV, human papilloma virus vaccine known as Gardasil produced by Merck, and, Cervarix from GlaxoSmithKline’s labs – has opened up more than a Pandora’s Box for me. A viper pit I have been dumped into. I am facing a Medusa of sorts, a monster I already battled in other arenas, but I never thought I’d be up against it as a social worker for foster youth.

For four and a half decades, I have witnessed up close the Medusa of Disaster Capitalism and the Unfettered Military Industrial Complex as a reporter in the Southwest USA and throughout Mexico and Central America.

Today, that mythical Medusa’s many snakes as hair strands is most troublesome: I call it the Military-Surveillance-Fossil Fuel-Penal-Medicine-Financial-Education-Media-Pharma-Digital Industrial Complex. It’s turned into an all-encompassing monster.

That reality is a given for many of us who question authority, who see a world better served as non-hierarchical, non-patriarchal and earth/ecosystems/cultures focused. The reader can go to the Universal Declaration of Human Rights  or something like the Earth Charter and get a sense of how millions of us have not only a yearning for something more just than the current global financial Medusa running things, but we’ve worked for that social-earth-economic justice hard and long.

Fear of Advocating for Clients

One of the rights we hold as self-evident, supposedly held as a God-given American tenet, is the unrestricted ability for any person to find work to both help the person survive in this pay-as-we-go society and to, in some cases, help a person achieve some sort of self-worth and dignity.

The careers I have had include college instructor/faculty, newspaper journalist, community organizer and social worker. My work in the past seven years includes working with adults with severe developmental disabilities; with adults in a memory care facility as their educator and outings lead. I’ve worked to help adults in a sheltered workshop find competitive employment; I have worked with clients deemed homeless/addicts/felons to gain skills, services and employment on their road to recovery-reentry-resuscitating.

I was working a pretty cool job most recently as a social worker/case manager for an independent living program, a suite of services set up nationally for foster youth, 16 to 21 years of age, mainly to get them to finish high school and go onto college or trade school. My gifts as teacher, outdoor educator, world traveler, communicator, and creative soul aided me in making deep and profound connections to youth who have seen the underbelly of life and face many challenges tied to the disconnected nature of living sometimes in dozens of foster care homes. Exposure to drug use, pornography, drug dealing, violence, sexual assault and criminal acts are just some of the histories of these youth.

I worked hands on with youth one-on-one and in groups. I got to take them on outings like surfing in the Pacific and a four-day conference at a private university. I had some level of independence and developed great relationships with other professionals in state, county, city public sector jobs and with foster parents and the youth. The job also afforded me decent training in all sorts of areas, including trauma-informed care and motivational interviewing.

Sex Ed and Me

I came face-to-face, though, with the inner workings of Planned Parenthood, as in my first intersection with PP while training to be a facilitator for one five-hour curriculum attempting to get youth to understand the high risks associated with alcohol use and unprotected sex.

The specific training I had taken as part of my job description was focused on case managers becoming trainers, titled Sexual Health and Adolescent Risk Prevention (SHARP). My former employers, Lifeworks Northwest, a 46-year-old non-profit, receives thousands of dollars from Planned Parenthood each year to allow PP to utilize our caseloads, youth, 16 to 21, characterized as high risk for homelessness, dropping out of school, substance abuse, pregnancy and contracting an STI, sexually transmitted infection:

“The goal of the Healthy Youth Collaborative is to reach youth by bringing evidence-based teen pregnancy prevention programs to scale. To achieve this goal, Planned Parenthood implements Healthy Youth Collaborative programming within each community, in four different settings including schools (middle and high school), health centers, community-based organizations, and juvenile justice facilities. A curriculum has been chosen so that there is an appropriate evidence-based program for each of these settings.”

I’m all for protecting youth and having myriad of ways to incite responsibility through education and modeling. What I found from the training was a bizarrely out-of-touch with current youth culture Planned Parenthood. I found the insistence to follow their curriculum word for word both interfering and hobbling. I also found a lot of condescension, and what I have seen in my many years working in educational circles: both a dumb-downing and infantilizing of many important aspects of a training or course.

While I have always supported the mission to help youth not face unwanted pregnancies, to have strong information and tools tied to sexual health and sexuality, and a place to obtain services for either preventing or curing STI’s/STD’s, I have also worked on the frontlines in El Paso as a volunteer escort for anyone seeking services at that Planned Parenthood. Those Saturday episodes found me face-to-face with angry, picket-bearing extremists who wanted to harass the women we were escorting in for family planning services. I even facilitated media workshops to that same Planned Parenthood on how to handle rough and pervasive anti-Planned Parenthood characters like those in the 1980s and ‘90s making headlines not only in the El Paso Times where I also worked but Time Magazine and the NYT.

Questioning Authority

Ironic, now, that just one month ago, I was in a PP second training, this time at the Planned Parenthood of the Great Northwest, and I was summarily not only banned from finishing the two-day course, Fundamentals of Sex, but I was then put on administrative leave in Portland by my former employer and then fired ten days later. I’ve pretty much exhausted the scenario tied to that banishment and termination here at Hormones Matter and other venues in the blog sphere.

I had no ax to grind with Planned Parenthood concerning training us – case managers — on how to communicate sex ed to youth. I expected to get through 16 hours of training with flying colors and a three-hour road trip back to Portland.

That did not happen, and Planned Parenthood – four trainers and two supervisors – contacted my employer to not only ban me from the second day of training, but fraudulently stated that I was against Western medicine, was untrainable related to the subject matter, and was a disruption to the learning environment for the other 39 students.

There wasn’t even a kernel of truth to what they stated to my former employer on Oct. 15; however, during my termination meeting Oct. 26, the HR director stated that “the trainers with Planned Parenthood stated you voiced your disagreement with vaccines.” The only voicing I did was anonymously, on paper, about Gardasil. Not vaccines in general.

The relationship between non-profits working with vulnerable youth, including homeless youngsters, and Planned Parenthood is more than just cooperative or symbiotic. My case exposes the fact Planned Parenthood’s falsehoods concerning my participation at a training led directly to my termination.

While I am currently receiving unemployment benefits after the Oregon State adjudicator contacted both my former employer and myself, and here are the findings below, I am really vulnerable on the job market because of the short duration as a case manager (six months) with Lifeworks Northwest when I was really committed for years on this job. The first thing coming to mind for prospective employers is “why such a short tenure with your previous employer?”

You ARE allowed benefits on this claim . . . .

Findings: You were employed by Lifeworks NW until Oct. 26, 2017 when you were fired because you received too many complaints about being unprofessional, confrontational and argumentative. This was not a willful or wantonly negligent disregard of the employer’s interest because there was no policy or rule violation. You deny the accusations of being a disruption to a training that occurred on October 16, 2017. Employer failed to respond to additional attempts to retrieve information.

Legal Conclusion: You were fired but not for misconduct connected with work.

They Say Follow the Money – How about Follow the Compassion!

Writing these articles does bring things into perspective, but anyone with a decent amount of psychological grounding will note that this journalistic process also opens up repeatedly the ludicrousness and trauma tied to what happened to me – wrongful termination without any due process.

I’ve used up my three “free” psychologist visits through the company’s EAP, employee assistance program. I’ve also reached out to a national legal firm on the viability of pursuing a case against Lifeworks Northwest but specifically Planned Parenthood.

I am disenchanted with the characterizations of me as unprofessional, confrontational and argumentative, since I was one of three males at a training with 45 total people, and also, I am working in a field – social services – predominately staffed and managed by females.

Given that, though, I still am following the money:

The 2015-16 budget from Lifeworks Northwest shows some of the money trail, i.e. revenue –

SERVICES BY CLIENT — $24,280,894
PUBLIC GRANTS & CONTRACTS — $16,645,143
CONTRIBUTIONS — $830,512
OTHER REVENUE — $220,952

TOTAL –$41,977,501

The money coming from Planned Parenthood to my former employer — which is money Planned Parenthood receives in the form of federal grant money largely from the Health and Human Services adolescent division – is significant in that Lifeworks NW has dozens of programs, and the Independent Living Program is relatively small so any funding coming into that program is significant.

What’s troubling is that I broke no policy, did not act bizarrely or unprofessionally, and did not engage in argumentative or combative behavior at the Planned Parenthood training, as the Oregon Employment Department’s findings belay –

“This was not a willful or wantonly negligent disregard of the employer’s interest because there was no policy or rule violation.”

The precipitating factor for Planned Parenthood essentially informing my employer that I was not trainable and that I was incapable of imparting sound, evidence-based sex ed information to my clients, was a handwritten suggestion/inquiry solicited by the trainers (stated by them to stay anonymous) after each of the seven modules. One of my two notes was a deep skepticism about one of Planned Parenthood’s money makers – the HPV vaccine, manufactured as Gardasil by Merck. I imparted disappointment that Planned Parenthood trainers were not even aware of or concerned about the negative press around Gardasil.

I never mentioned any disregard for the sex ed training, nor did I state I would not allow my clients to pursue getting any contraceptive or vaccine.

It was clear that the training was all about Planned Parenthood’s word on everything or the highway.

I am not a big fan of any forced (or group-think) hyper rah-rah-rah of any organization, or what I am now calling the “ich liebe dich Planned Parenthood uber alles in der Welt … I love you Planned Parenthood above anything else in the world” syndrome.

Of note, in my six months working with 40 youth, I was asked more than just occasionally about the safety of IUDs, birth control pills, the transdermal patch, Depo-Provera and once, the Gardasil series of vaccines. I encouraged those youth to check out the Planned Parenthood site and to use Google to find out if there were any large forums commenting on those products so my youth would have more information to make an informed choice.

Planned Parenthood never gave me a chance to meet with the three trainers and two supervisors to discuss their concerns. And, after the banishment, my former employer never sought testimony from me concerning my beliefs about contraception and abortion, nor did they solicit comments from two fellow case managers who were at the training with me to determine my participation and commentary at the training.

If the reader looks at the $16.6 million in public grants and contracts the Lifeworks non-profit received last year, ipso facto this large Portland non-profit depends significantly on money coming from the state, county, and US taxpayer in the form of Planned Parenthood.

It’s All About Language, Narrative Framing, Intent

“What, really, is a word? In its written form, it’s a great many things. It is a symbol. A representation of individual phonics that, when assembled in such a sequence, produces a gestalt. Rearrange the letters corresponding to those sounds, and you’ve eliminated or transformed that symbol. A word is an idea. Not simply a representation of an idea, but an idea in itself. The idea that what we think can not only be thought, not only expressed verbally, but also textually, a physical marking of the presence of thought — the evidence of its spatial existence.” —  Daniel Choudhury, What’s Your Word Worth?

Before I go further, a quick glossary of terms should be inserted to help the reader see the context from which I am writing this third part of a series I could thumbnail title as “ My Run-in with Gardasil, Planned Parenthood, and a Culture of No Questions Asked – A Firing Story!”

Sacrosanct – An adjective is defined as anything (principle, place or routine) regarded as too important or valuable to be interfered with.
Antivaxxer – A derogatory term used by industry to describe individuals who question vaccine safety or efficacy; typically parents of children injured by vaccines.
Planned Parenthood – A noun defined as a nonprofit organization that does research into and gives advice on contraception, family planning, and reproductive problems.
Big Pharma – A noun defined as large pharmaceutical companies (= companies producing medical drugs), especially when these are seen as having a powerful and bad influence.
Whistleblower – A noun defined as a person who tells someone in authority about something illegal that is happening, esp. in a business or government.

Of course, I could insert the Urban Dictionary’s definitions of these items, and I certainly could link profoundly to various narratives around the mission, vision, and history of Planned Parenthood, what I would call the good, the bad and the ugly of its roots in the 1920’s with Margaret Sanger, a slew of eugenicists, and its oddly racist backers of contraception and sterilization. Sanger founded the American Birth Control League in 1921, and 21 years later changed its name to Planned Parenthood.

Note that I am now in dangerous territory for many readers – the sacrosanct right to seek contraceptive and abortion services. In some ways, I have crossed that line in the sand by criticizing that Sacred Cow in the minds of many, Planned Parenthood.

I am really just attacking the malfeasance and unethical behavior and then treatment of me as a human being in the context of a Planned Parenthood training. I didn’t even get out of the gate, so to speak, with an adult, robust, discussion about the HPV, cervical cancer, the vaccine and its risks.

Almost everything now that I written about Big Pharma-GSK-Merck-HPV Vaccine-Planned Parenthood came AFTER I was fired on the word of Planned Parenthood staff.

Like this doozy – the 2017 Lasker Awards (sort of dubbed the US Nobel Prize) was given to Planned Parenthood and the developers of the HPV vaccine September of this year:

The winners “are being honored for their work in basic and clinical medical research and in public service,” Claire Pomeroy, MD, president of the Albert and Mary Lasker Foundation, said at a teleconference today.

Douglas R. Lowy, MD, and John T. Schiller, PhD, both from the National Cancer Institute, Rockville, Maryland, won the Lasker-DeBakey Clinical Medical Research Award for a major advance that improves the lives of many thousands of people. Their research centers on the development of HPV vaccines that prevent cervical cancer and other tumors caused by HPVs.

Planned Parenthood won the Lasker-Bloomberg Public Service Award for providing vital health services and reproductive care to millions of women for more than 100 years.

The Lasker-Bloomberg Public Service Award comes with a $250,000 award for each winner. Planned Parenthood in 2012 received 45 percent of its revenues from government health services grants and reimbursements. Now that’s around 35 percent of their revenue stream. In addition, in 2012, 16 percent of revenues were tied to non-medical programs.

From 1939 to 1942 Margaret Sanger was part of the Birth Control Federation of America alongside Mary Lasker and Clarence Gamble in the Negro Project, an effort to deliver birth control to poor black people.

I know my research into Big Pharma’s duplicitous, double-dealing and dangerous schemes is not as risky as throwing down criticism of Planned Parenthood. At Hormones Matter, maybe the idea of questioning Gardasil and Cervarix or even the birth control pill, especially by a white male, also is not dangerous territory.

The reality of how suspect, dangerous and medically unnecessary the HPV vaccine is also puts me into a league of its own vis-à-vis the antivaxxer campaigners, a title I have never adopted or will adopt. I never expected this pebble into the pond – my superficial questioning a vaccine – to turn into a tsunami-like rippling effect in my life.

Vaccines, Science, Anti-Science, Marketing, Propaganda, Resistance to Business as Usual a la Big Pharma

Interestingly, during my research, I came across a story out this February about a meteorologist who questioned the safety of vaccine schedules and chemical ingredients being fired, and hit with the Scarlet Letter, A, as an Antivaxxer.

Did WGBH News hire a science reporter who doesn’t believe in science?

That’s the question being asked by some employees of the PBS affiliate after learning that Mish Michaels, a former meteorologist at WBZ-TV who has been outspoken in her controversial belief that vaccines cause autism, had been hired as the station’s new science reporter.

Among those who wondered whether Michaels was right for the job was Jim Braude, host of WGBH News’s “Greater Boston,” for which Michaels was supposed to report stories. We’re told that Braude this week raised his concerns with station bosses, including WGBH News GM Phil Redo and “Greater Boston” executive producer Bob Dumas, and they have since changed their minds.

“The decision was made that [Michaels] is not a good fit for ‘Greater Boston’ and she won’t be working there, Braude stated.

Most of the 240 comments on the Boston Globe website that carried the news were stinging like this one:

cra-cra-in-sherborn: 02/08/17
Vaccines work because of herd immunity. Everything has risks and benefits and with vaccines the benefit outweighs the risk. What gets me is the antivaxxies lost in the world of narcissistic oblivion who decide they don’t want to take the small risk of vaccinating their kids and mooch off the herd immunity that everyone else created by vaccinating their own kids. If everyone opted out we would all have measles mumps and small pox.

Vaccines should be required for school entry no exceptions. Or home school your kids.

or this one:

mauthedog: 02/09/17
Through work over the last thirty years I’ve made friends across the United States. A few are anti-vaxxers. They constantly share anti-vaxxer posts on Facebook. Over the last couple of years I’ve noted how they have started attacking the “herd” theory and even attacking flu shots.

Most of them are quite religious. Several are right-wing evangelical Christians. They are generally anti-science.

During a FB discussion, one wrote to me how I “chose Science over God.” I didn’t realize there was a choice.

You can’t reason with them. Facts don’t matter. They’ve told me—-Tests can be faked. The CDC is a profit center. It’s about money, not safety. The government is helping big pharma. The government is covering it up.

And so on.

I fear under the current administration, this quackery will grow worse.

Using one giant latex brush, then, by questioning the safety of Gardasil at a Planned Parenthood training, I am now being painted with that same broad stroke into the same corner as the anti-evolution, anti-science “quacks or loonies” or whatever pejorative is the flavor of the digital hour.

Talk of the herd effect is now parlayed into the “rule of the mob,” as everyone, including mainstream and progressive media, attack anyone who dares question Gardasil or the MMR — all the scientists and researchers making a connection with vaccinations like HPV to physical (and brain specific) injuries are vilified. Or the fact that Merck has paid out millions of dollars (and we don’t have all the dollars tied to really how much Merck is shelling out because of courts awarding damages are tied to non-disclosure provisos) gets swept under the rug as “nuisance lawsuits”?

Yet, the story of HPV vaccine and injuries and deaths keeps coming around: Japan pulls Gardasil off the shelves three years ago. A lawsuit, class action, followed this move:

Lawyer Masumi Minaguchi, a representative from the planned lawsuit’s defense team, told a news conference in Tokyo the victims will file the suit sometime after June against the central government, GlaxoSmithKlien PLC, the maker of Cervarix, and Merck Sharp & Dohme Corp., the maker of Gardsil, at four district courts in Tokyo, Nagoya, Osaka and Fukuoka.

“The victims wish to live a peaceful life and prevent further suffering by finding out the truth (about the vaccine side effects),” Minaguchi added.

She said the defense team will seek additional plaintiffs to join the lawsuit by holding seminars in April and May. Currently, 12 plaintiffs are taking part in the suit, according to Minaguchi.

Saitama Prefecture resident Nanami Sakai, who plans to be one of the plaintiffs, was one of four to attend the news conference. The 21-year-old, who was given Cervarix twice in 2011, said she did not receive information about the pros and cons of the vaccine before receiving the injections.

“I’d like to know why I was left scarred by the vaccine, why I was not able to receive proper treatment right away and why my situation was not adequately conveyed to the state,” Sakai said.

Sitting in a wheelchair, Sakai said she has numbness in the right side of her body, back and around her chest.

And what about in Colombia, and the injured, dead and lawsuits there tied to HPV vaccine?

Lloyd Phillips, an American researcher of infectious diseases and genetics, has studied the adverse effects of Gardasil for five years. His work has revealed how Gardasil works differently in different people. He has documented related and biologically plausible mechanisms of action which could cause the many serious and life-threatening side effects which are being reported by girls and young women around the world after receiving the HPV vaccine.

In Colombia we have a potential crisis of major proportions resulting from the use of Gardasil because it is “free and compulsory” by “Law of the Republic”. It is assumed that this HPV vaccine is effective when used to combat cervical cancer, which can be caused by human papilloma virus. However, this vaccine has been hotly debated internationally for allegedly being dangerous and ineffective. It is currently being administered in Colombia without obtaining informed consent from young girls and their parents as to the potential and unknown risks of use.

Is the Ending Full-Circle Back to Bad Pharma and Big Non-profits?

So where does the next installment — part four — go now after not getting to the two big definitions left in my glossary – Big Pharma and Whistleblower? There are literally thousands of documents out there from researchers and scientists and whistleblowers on just what is happening to the human population tied to the vaccine for HPV, let alone those other mandatory childhood vaccinations we are supposed to get for our children before they turn three.

Listening to hours of radio shows on the blog-sphere, and viewing hours of interviews and documentaries on the internet and Netflix, I may sound jaded or exhausted, but alas, I am not. The only way through this is to keep up some hope that change is possible, whether as a climate-environment activist or social worker. Writing is just one rung in the ladder helping me and I hope you, kind reader, get above the miasma and smoke and mirrors our Western For-Profit Medical Industrial Complex has deployed with their endless billions for lobbying and marketing and subterfuge and obfuscation.

Keep reading until Part Four comes out.

“No one should approach the temple of science with the soul of a money changer.” —  Thomas Browne

“Big Pharma needs sick people to prosper. Patients, not healthy people, are their customers. If everybody was cured of a particular illness or disease, pharmaceutical companies would lose 100% of their profits on the products they sell for that ailment. What all this means is because modern medicine is so heavily intertwined with the financial profits culture, it’s a sickness industry more than it is a health industry.” ― James MorcanThe Orphan Conspiracies: 29 Conspiracy Theories from The Orphan Trilogy

HPV Vaccine Debate — Don’t Ask, Don’t Tell 
Gardasil Scandal Brewing in Colombia 
Four Year Analysis of Adverse Reactions to Gardasil 
Gardasil Syndrome 
Clinical Trials 
In The Know w/ Lloyd W. Phillips (he starts talking at 10:53 into the interview)
Vaccines/Gardasil 

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Weight Gain and Hormonal Contraceptives

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Once upon a time, a 26-year-old woman went to her doctor and asked to be put on the new birth control pill that allowed women to only have four periods a year. She had seen it advertised on television. Four months later, 15 pounds heavier and suffering from mild depression, she returned to the doctor feeling miserable. The doctor told her the weight gain and depression were not from the pill because those were not side effects of hormonal birth control. This left the young woman feeling like it was her fault she had gained weight. Needless to say, that didn’t help with the depression. But she switched back to her original birth control pill and lived happily (but heavily) ever after. Well, until it gave her a stroke two years later.

I’ve written a lot about my stroke and about blood clots and birth control pills, but there are many other side effects from hormonal birth control. More often than not, we are told that these side effects do not exist; that they are all in our heads. Are they? Or are we simply being ignored and lied to?

What Does The Research Show?

When researching my thesis, I was interested in finding out what women knew about the risks associated with birth control pills. I created a survey based on a published study by researchers in this field. The original study outlined which side effects were and were not associated with birth control pills. The survey used in my thesis demonstrated the following:

“When the women were asked to select which risk factors were associated with birth control pills, most women, 76.7% of the 313 who answered the question, selected blood clots. Weight gain, which is not considered a health risk or even a side effect of birth control pills, was the selection most chosen (79.9%).”

The number one answer most women chose was weight gain, yet all the research I read said that weight gain was not a side effect of birth control pills. My own doctor had told me it wasn’t a side effect when I stood before her 15 pounds heavier after switching pills. Even as I wrote my thesis, I wondered how we could all be so wrong. Well, it turns out we weren’t. The pill can cause weight gain. And they knew it could, even back in 1970. The following is testimony from the Nelson Pill Hearings.

Dr. Francis Kane (page 6453): [In a Swedish study of 344 women] Of the 138 women who stopped using the medication, weight gain and emotional disturbances were the most frequently reported, 26.1 percent and 23.9 percent.

Dr. Louis Hellman (page 6203): My private patients… come off the pill because of a host of minor reactions. The most prevalent one is weight gain. The modern American girl just does not want to gain 5 or 10 pounds if she can help it.

What About Today’s Birth Control Pills?

I took another look at what I could find out about weight gain and hormonal contraception now. According to WebMD:

“When birth control pills were first sold in the early 1960s, they had very high levels of estrogen and progestin. Estrogen in high doses can cause weight gain due to increased appetite and fluid retention. So, 50 years ago they may indeed have caused weight gain in some women. Current birth control pills have much lower amounts of hormones. So weight gain is not likely to be a problem.”

Maybe larger doses of hormones cause more weight gain. But I don’t think that means that smaller doses cause none. And what about taking that smaller dose for a decade or more?

Most current medical information dismisses weight gain completely. On the Mayo Clinic website’s FAQ page for birth control pills it says:

“Do birth control pills cause weight gain? Many women think so. But studies have shown that the effect of the birth control pill on weight is small — if it exists at all.”

That’s right, ladies. Just like your menstrual cramps, weight gain on the pill probably doesn’t exist. But wait, the Mayo Clinic says there are studies that show hormonal contraceptives don’t cause weight gain. Where are these studies?

Inconclusive? Or Incorrect?

A recent meta-analysis (2014) conducted by Cochrane (an independent group that reviews randomized controlled trials and organizes medical research information) found the following:

Available evidence was insufficient to determine the effect of combination contraceptives on weight, but no large effect was evident. Trials to evaluate the link between combination contraceptives and weight change require a placebo or non-hormonal group to control for other factors, including changes in weight over time.

You mean to tell me in the 40+ years since the Nelson Pill Hearings we haven’t been able to conduct one conclusive study to determine how hormonal contraception affects weight? Perhaps it’s time to start asking why. All those studies that provided insufficient evidence, who funded them and who might stand to lose if they were conclusive? I don’t know for sure but I do know that one of the few things women fear as much as an unintended pregnancy is weight gain. Even the staunchest feminists among us often fret over our figures.

According to Naomi Wolfe’s The Beauty Myth, “thirty-three thousand American women told researchers that they would rather lose ten to fifteen pounds than achieve any other goal.” Setting aside how disturbing that is, we can easily see how the fact that hormonal birth control can cause weight gain might adversely affect the pharmaceutical industry’s bottom line (pardon the pun).

At the Nelson Pill Hearings, there were at least a half dozen experts–doctors specifically chosen to testify before Congress–that mentioned weight gain as a side effect of the birth control pill. Including ones who admittedly worked for the pharmaceutical industry. But now, nearly five decades later, the research is inconclusive. Doctors are telling patients that hormonal contraceptives are not responsible for weight gain, yet 80% of women surveyed thought that weight gain was a side effect. Like so much surrounding the pharmaceutical industry, something doesn’t add up here. And who is paying the difference? Women. Yet again we are being told that it’s all in our heads. Have you had experience gaining weight on hormonal birth control?

Further Testimony on Weight Gain

This testimony from the Nelson Pill Hearings just scratches the surface of the side effects caused by hormonal contraceptives. I’ll be expanding more on a lot of this testimony in future articles. But perhaps Dr. Victor Wynn explained most succinctly how these side effects manifest when he testified (page 6303):

When I say these changes occur, I mean they occur in everybody, more in some than in others, but no person entirely escapes from the metabolic influence of these compounds. It is merely that some manifest the changes more obviously than others.

Dr. Robert Kistner (page 6082): I tell her about the side effects plus a weight gain edema and I may even give her a prescription for this.

Dr. John Laragh (page 6165): We do not have any firm clues. But it does look as though those who accumulate salt and water and gain weight on the oral contraceptives might be especially vulnerable [to increased hypertension].

Dr. Francis Kane (page 6449): Complaints of moodiness, being cross and tired, alterations in sexual drive, weight gain, edema, and insomnia were commonest in the group using the estrogen-progestin group.

At the hearings, Dr. Herbert Ratner (page 6737) was asked by James Duffy, minority council:

Mr. Duffy: You use the word “disease” here. Disease to me seems to be a pretty strong word and I am just curious why you would consider weight change to be a disease?

Dr. Ratner: You realize that obesity is one of our major problems in this country.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

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Hormones Matter Top 100 Articles of 2015

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Happy New Year, everyone. We have another remarkable year under our belts. Hormones Matter continues to grow month after month. This year, despite the site being down for a month in September, we had over 815,000 visitors, most staying quite a while to read our articles.

Since inception, we’ve published close to 900 articles, many are read by thousands of readers every month. The hysterectomy and endometriosis articles continue to draw large crowds, demonstrating the great need for information in these areas of women’s health.

Our success is thanks to a fantastic crew of volunteer writers who spend countless hours researching complex medical topics, making connections, identifying unconventional therapeutic opportunities, and bringing to light, what are often, invisible illnesses. Without these incredibly talented and compassionate individuals, Hormones Matter would not exist.

Before we begin the new year in earnest, let us take a moment to thank all of the writers of Hormones Matter.

Thank You Hormones Matter Writers!

 

Below are the articles and authors who made the top 100 list for 2015. If you haven’t read these articles, it’s time to do so. If you like them, share them and share our site so we can continue to grow. If you were helped by any of our articles, take a moment and send the writer a thank you note.

This year, we thought we’d do something a little different and include the 25 all-time favorite articles on Hormones Matter. Be sure to scroll down to the second table and take a look. The numbers are quite impressive.

Since we are run by volunteers and unfunded, feel free contribute a few dollars to cover the costs of maintaining operations. Crowdfund Hormones Matter. Every dollar helps.

If you’d like to share your health story or join our team of writers: Write for Us.

Hormones Matter Top 100 Articles of 2015

Article Title and Author

Reads

1. Post Hysterectomy Skeletal and Anatomical Changes -WS 50,814
2. Sex in a Bottle: the Latest Drugs for Female Sexual Desire – Chandler Marrs 47,910
3. Sexual Function after Hysterectomy – WS 28,898
4. In the ER Again – Heavy Menstrual Bleeding -Lisbeth Prifogle 25,326
5. Endometrial Ablation – Hysterectomy Alternative or Trap? -WS 25,048
7.  Adhesions: Cause, Consequence and Collateral Damage – David Wiseman 22, 868
8. Is Sciatic Endometriosis Possible? – Center for Endometriosis Care 11,701
9. Endometriosis: A Husband’s Perspective – Jeremy Bridge Cook 11,626
10. A Connection between Hypothyroidism and PCOS – Sergei Avdiushko 11,024
11. Often Injured, Rarely Treated: Tailbone Misalignment – Leslie Wakefield 10,580
12. Hysterectomy: Impact on Pelvic Floor and Organ Function – WS 8,494
13. Pill Bleeds are not Periods – Lara Briden 8,440
14. Silent Death – Serotonin Syndrome – Angela Stanton 8,408
15.  An Often Overlooked Cause of Fatigue: Low Ferritin – Philippa Bridge-Cook 8,374
16. Wide Awake: A Hysterectomy Story – Robin Karr 7,733
17. How Hair Loss Changed My Life – Suki Eleuterio
18. The High Cost of Endometriosis – Philippa Bridge-Cook 7,170
19. Skin Disorders post Gardasil – Chandler Marrs 6,891
20. Essure Sterilization: The Good, the Bad and the Ugly – Margaret Aranda 6,820
21. Love Hurts – Sex with Endometriosis – Rachel Cohen 6,779
22. Dehydration and Salt Deficiency Migraines – Angela Stanton 6,638
23.  Adverse Reactions, Hashimoto’s Thyroiditis, Gait, Balance and Tremors – Chandler Marrs 6,445
24.  Stop the Metformin Madness – Chandler Marrs 6,400
25. Lupron, Estradiol and the Mitochondria: A Pathway to Adverse Reactions – Chandler Marrs 6,110
26. Endometriosis after Hysterectomy – Rosemary Finnegan 6,093
27. The Reality of Endometriosis in the ER – Rachel Cohen 5,962
28. Mittelschmerz – what should you know – Sergei Avdiushko 5,780
29.  Red Raspberry Leaf Tea to Relieve Menstrual Pain – Lisbeth Prifogle 5,586
30. Mommy Brain: Pregnancy and Postpartum Memory Deficits – Chandler Marrs 5,437
31. Parasites: A Possible Cause of Endometriosis, PCOS, and Other Chronic, Degenerative Illnesses – Dorothy Harpley-Garcia 5,414
32.  Endometriosis and Risk of Suicide – Philippa Bridge-Cook 5,413
33.  Fluoroquinolone Antibiotics and Thyroid Problems: Is there a Connection? – JMR 5, 228
34. Adenomyosis – Philippa Bridge-Cook 5,022
35.  Gardasil: The Controversy Continues – Lisbeth Prifogle 4,809
36.  Hyperemesis Gravidarum – Severe Morning Sickness: Are Mitochondria Involved? – Chandler Marrs 4,801
37.  Oral Contraceptives, Epigenetics, and Autism – Kim Elizabeth Strifert 4,452
38.  High Blood Pressure in Women: Could Progesterone be to Blame? – Chandler Marrs 4,446
39. My Battle with Endometriosis: Hysterectomy at 23 – Samantha Bowick 4,288
40. Thiamine Deficiency Testing: Understanding the Labs – Derrick Lonsdale 4,045
41. My Battle with Endometriosis and Migraines – Angela Kawakami 3,839
42. Tampons with Glyphosate: Underpinnings of Modern Period Problems? – Chandler Marrs 3,835
43. Cipro, Levaquin and Avelox are Chemo Drugs – Lisa Bloomquist 3,792
44. Hysterectomy or Not – Angela’s Endometriosis Update – Angela Kawakami 3,750
45. Warning to Floxies: Beware of New Med for Psoriatic Arthritis – Debra Anderson 3,691
46.  DES – The Drug to Prevent Miscarriage Ruins Lives of Millions – DES Daughter 3,655
47.   Sphincter of Oddi Dysfunction (SOD) – Brooke Keefer 3,540
48. Progesterone for Peripheral Neuropathy – Chandler Marrs 3,278
49. The Fluoroquinolone Time Bomb – Answers in the Mitochondria – Lisa Bloomquist 3,251
50. Why is PCOS so Common? – Lara Briden 3,211
51.  Pregnancy Toes – What Sugar does to Feet – Angela Stanton 2,971
52.  Five Half-truths of Hormonal Contraceptives – The Pill, Patch and Ring – Joe Malone 2,834
53.  Five Years After Gardasil – Ashley Adair 2,831
54. Bleeding Disorders Overlooked in Women with Heavy Periods – Philippa Bridge Cook 2,826
55.  Is Gardasil Mandated in Your State? – Lisbeth Prifogle 2,814
56.  Is Prenatal Dexamethasone Safe: The Baby Makers’ Hubris – Chandler Marrs 2,808
57. Porn Brain – A Leading Cause of Erectile Dysfunction – Chandler Marrs 2,792
58. Lupron and Endometriosis – Jordan Davidson 2,752
59.  Endometriosis, Adhesions and Physical Therapy – Philippa Bridge-Cook 2,746
60.  Glabrata – A Deadly Post Fluoroquinolone Risk You’ve Never Heard About – Debra Anderson 2,703
61. Are You Vitamin B12 Deficient? – Chandler Marrs 2,635
62. Topamax: The Drug with 9 Lives – Angela Stanton 2,635
63.  Cyclic Vomiting Syndrome – Philippa Bridge-Cook 2,622
64.  The Endo Diet: Part 1 – Kelsey Chin 2,614
65.  Endometriosis and Adhesions –  Angela Kawakami 2,544
66.  Thyroid Disease Plus Migraines – Nancy Bonk 2,530
67.  Is it Endometriosis? – Rosalie Miletich 2,414
68. Hysterectomy, Hormones, and Suicide – Robin Karr 2,412
69.  Why I am Backing the Sweetening the Pill Documentary – Laura Wershler 2,321
70.  I Wanted to Die Last Night: Endometriosis and Suicide – Rachel Cohen 2,271
71.  How Can Something As Simple As Thiamine Cause So Many Problems? – Derrick Lonsdale 2,456
72.  Thyroid Dysfunction with Medication or Vaccine Induced Demyelinating Diseases – Chandler Marrs 2,034
73. Angela’s Endometriosis Post Operative Update –  Angela Kawakami 2,017
74.  Fluoroquinolone Antibiotics Damage Mitochondria – FDA Does Little – Lisa Bloomquist 1,993
75.  Endometriosis and Pregnancy at a Glance – Center for Endometriosis Care 1,969
76.  Don’t Take Cipro, Levaquin or Avelox If…. – Lisa Bloomquist 1,960
77.  Gardasil Injured – Dollie Duckworth 1,898
78. Fear of Childbirth Prolongs Labor – Elena Perez 1,888
79. Fluoroquinolone Poisoning: A Tale from the Twilight Zone – Kristen Weber 1,883
80. Personal Story: Thyroid Cancer – Myrna Wooders 1,880
81. Recurrent Miscarriage – Philippa Bridge-Cook 1,873
82. Recovering from the Gardasil Vaccine: A Long and Complicated Process – Charlotte Nielsen 1,842
83. Pelvic Therapy for Endometriosis, Adhesions and Sexual Pain – Belinda Wurn 1,818
84. Hormones, Hysterectomy and the Hippocampus – Chandler Marrs 1,777
85. Why Fatigue Matters in Thyroid Disease – Chandler Marrs 1,718
86. How Do You Deal with the Lasting Effects of Endometriosis? – Samantha Bowick 1,697
87. Depression with Endometriosis – Samantha Bowick 1,678
88. Easing Endometriosis Pain and Inflammation with Nutrition –  Erin Luyendyk 1,648
89. Anti-NMDAR Encephalitis and Ovarian Teratomas – Chandler Marrs 1,634
90. Autoinflammatory Syndromes Induced by Adjuvants: A Case for PFAPA – Sarah Flynn 1,595
91. Endometriosis Awareness Month: A Wish Noted – Philippa Bridge-Cook 1,513
92. The Role of Androgens in Postmenopausal Women – Sergei Avdiushko 1,477
93. It Wasn’t by Choice: Dysautonomia – Margaret Aranda 1,454
94. Fluoroquinolone Antibiotics Associated with Nervous System Damage – Lisa Bloomquist 1,453
95.  Vitamin D3 and Thyroid Health – Susan Rex Ryan 1,439
96. Dealing with Doctors When You Have Undiagnosed Endometriosis -Angela Kawakami 1,439
97. Endometriosis and Being a Trans Person: Beyond Gendered Reproductive Health – Luke Fox 1,436
98. Cyclic Vomiting Syndrome and Mitochondrial Dysfunction: Research and Treatments – Philippa Bridge-Cook 1,430
99. Living with Ehlers Danlos is Hell – Debra Anderson 1,420
100. What is Fluoroquinolone Toxicity? – Lisa Bloomquist 1,415

Hormones Matter All-Time Top 25 Articles

Article Title and Author

Reads

1. Post Hysterectomy Skeletal and Anatomical Changes -WS 105,336
2. Sex in a Bottle: the Latest Drugs for Female Sexual Desire – Chandler Marrs 99,098
3. Endometrial Ablation – Hysterectomy Alternative or Trap? -WS 70,999
4. Adhesions: Cause, Consequence and Collateral Damage – David Wiseman 40,299
5. In the ER Again – Heavy Menstrual Bleeding -Lisbeth Prifogle 39,821
7.  Sexual Function after Hysterectomy – WS 35,188
8. A Connection between Hypothyroidism and PCOS – Sergei Avdiushko 31,193
9. Is Sciatic Endometriosis Possible? – Center for Endometriosis Care 24,691
10. Endometriosis: A Husband’s Perspective – Jeremy Bridge-Cook 23,251
11. Skin Disorders post Gardasil – Chandler Marrs 18,105
12.  Gardasil: The Controversy Continues – Lisbeth Prifogle 14,174
13.  Wide Awake: A Hysterectomy Story – Robin Karr 14,134
14.  Endometriosis and Risk of Suicide – Philippa Bridge-Cook 13,836
15.  Love Hurts – Sex with Endometriosis – Rachel Cohen 13,782
16. Endometriosis after Hysterectomy – Rosemary Finnegan 13,294
17. Hysterectomy: Impact on Pelvic Floor and Organ Function – WS 13,056
18.  Adverse Reactions, Hashimoto’s Thyroiditis, Gait, Balance and Tremors – Chandler Marrs 12,901
19.  How Hair Loss Changed My Life – Suki Eleuterio 12,835
20. Mittelschmerz – what should you know – Sergei Avdiushko 11,919
21.  Often Injured, Rarely Treated: Tailbone Misalignment – Leslie Wakefield 11,521
22.  An Often Overlooked Cause of Fatigue: Low Ferritin – Philippa Bridge-Cook 10,821
23.  Mommy Brain: Pregnancy and Postpartum Memory Deficits – Chandler Marrs 10,591
24. Adenomyosis – Philippa Bridge-Cook 10,249
25.  I Wanted to Die Last Night: Endometriosis and Suicide – Rachel Cohen 9,826
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Blood Clots while on Hormonal Contraceptives: Fact or Fear Mongering?

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A few weeks ago, someone posted a news article on Facebook about another young woman who almost died from her hormonal birth control. One Facebook commenter made a remark that she hated the fear mongering that goes on about hormonal birth control in the news. I, on the other hand, truthfully wish more women knew what to fear. My 29-year-old daughter Julia died in 2013 from massive bi-lateral pulmonary embolisms while using NuvaRing as her birth control. We had just celebrated her marriage to a wonderful young man. Julia had been married exactly five weeks on the day she died. I cannot even begin to describe the grief we feel about her death to this day.

That Facebook comment made me think about what I now see as the fear mongering that the medical community engages in when they insist that the risk of blood clots during pregnancy and postpartum (after delivery) must always be mentioned to put the risk of blood clots “in perspective.” I began to wonder if we really know enough about the risks of blood clots with hormonal contraceptives.

Beyond Fearmongering: Learning from the Families who Lost Loved Ones to Hormonal Contraceptives

My daughter’s death led me to meet Joe Malone whose 23-year-old daughter Brittany died in 2012, also while using NuvaRing. Our daughters’ deaths have taken us on a long and frustrating journey to learn more about combination hormonal contraception (CHCs) and why our daughters died.

Joe and I understand why the medical community wants to make sure that women use some form of birth control. Maternal mortality is very high, especially in third-world countries. There are many health complications and dangers for women during pregnancy and in the weeks after delivery from a variety of causes. The risk of a blood clot is high. However, we now see how the information given about the risks for blood clots during pregnancy and postpartum is presented in such a way that seems intent on scaring women into taking hormonal contraceptives. There is little discussion about safety between the various types of hormonal birth control (pill, patch, ring, IUD or shot), or other options, such as a copper IUD or other non-hormonal methods. Every hormonal contraceptive and every formulation is pronounced safe and the risk of a serious event is declared rare.

Women are told to talk with their healthcare provider about these risks to learn more. We have found that this suggestion is insufficient because many of these providers themselves, do not understand the different risks associated with each contraceptive formulation/brand.

Inevitably, accompanying any mention of risk from a hormonal contraceptive is the stark warning that the danger of a venous thromboembolism (VTE) – a blood clot in leg or lung) is higher while pregnant or postpartum. We have learned the hard way that the risk of a blood clot may be higher, but the possibility of death from a PE while using combined hormonal contraception is even greater.

Risk for Blood Clots with Hormonal Contraceptives versus Pregnancy or Postpartum

After careful review of data from various governmental and independent agencies (see below for discussion), we now believe that the overemphasis on the risk of VTE in pregnancy creates a false sense of security regarding the safety of combined hormonal contraceptives compared to pregnancy. It minimizes the reality that something very dangerous can happen to a small, but recognizable, percentage of women who use hormonal contraceptives. Women are led to believe that hormonal contraceptives are much safer than being pregnant due to the VTE risk in pregnancy. Women are not instructed on how to recognize the early warning signs of a dangerous and potentially deadly blood clot, and sadly, we also discovered that neither are their doctors. According to data from the CDC,

more U.S. women died from pulmonary embolisms while using a combination hormonal birth control than from pulmonary embolisms while pregnant or postpartum in 2011.

There were approximately 69 deaths in the U.S. from pulmonary embolisms during pregnancy and post-partum in 2011 (the latest date for which these numbers are available), compared with approximately 307 deaths due to pulmonary embolisms for women who used a combined hormonal contraceptive pill, patch or ring in 2013 in a recent analysis Joe and I completed. A full analysis is posted on BirthControlSafety.org.

We believe the reason there are fewer deaths from a pulmonary embolism during pregnancy is that most women who are pregnant or have recently given birth are monitored much more carefully than women who use hormonal contraceptives. A woman who utilizes birth control pills, patches or a ring is seen only annually by her physician and very rarely advised of the signs and symptoms of blood clots.

When signs of potential blood clots emerge, such as chest pain, difficulty breathing or leg pain, women are told that they have bronchitis, pneumonia, asthma or a pulled muscle. You can read first-hand accounts from both men and women on a site called stoptheclot.org. When you read these stories, you hear how the medical community has a very difficult time diagnosing deep vein thrombosis or pulmonary emboli. People who go to their doctor with the symptoms of a blood clot in their lungs or leg, are more likely than not, told to take an antibiotic, a pain reliever or muscle relaxant and come back later. For many, later is often too late.

Women Who Die from Contraceptive Induced Blood Clots

Our review of the data suggest more U.S. women die from VTEs while using a combined hormonal contraceptive than during pregnancy or postpartum. This is in contrast to what is commonly reported.

Tragically, a significant number of women do die during pregnancy and the postpartum period, but they die from a variety of reasons that have nothing to do with a pulmonary embolism. You can read the list of other reasons that women die while pregnant or postpartum in the list from the CDC website. Some of the reasons for these deaths are preeclampsia, hemorrhage, and complications of caesarean section: many conditions that only occur during pregnancy or postpartum.

A 2015 study by Vinogradova, Coupland, and Hippisley-Cox published in the British Medical Journal on the use of combined oral contraceptives and risk of venous thromboembolism [8] put the risk at an even higher rate than the rates we used from the European Medicines Agency (EMA). So it is likely that we underestimated death rates associated with contraceptive induced blood clots.

Next time you read the disclaimer that “Pregnancy and the postpartum period puts a woman at higher risk for a VTE” maybe you’ll remember that this claim may not be entirely true. From what we can tell, more women die of a pulmonary embolism while using combination hormonal birth control than while pregnant or in the postpartum. Hopefully, women will become better educated to take care of their health issues before, during, and after pregnancy. In the meantime we need to educate every woman about what combined hormonal contraceptives do to a woman’s body.

Calculating the Risk for Death by Venous Thromboembolism

The CDC monitors Maternal Mortality and publishes figures on their website. For all deaths reported in 2011, “702 were found to be pregnancy-related.” This total includes deaths that occurred for a full year after childbirth [1] they also report that 9.8% of maternal deaths during pregnancy and postpartum are attributed to thrombotic pulmonary embolism. We calculated that a 9.8% rate equaled 69 deaths in 2011. At present, there are no published mortality figures from the CDC for 2013.

It is difficult to find the number of women who die from a blood clot in their lungs while using a hormonal contraceptive. The FDA’s Adverse Event database is voluntary, inconsistent and difficult to interpret. Some columns, such as the Outcome column are left blank. Even the FDA has acknowledged in the past that only 10 to 15% of adverse events are reported [2]. The FDA requires that pharmaceutical companies report adverse events, but no one else is required to report to the FDA or even to the pharmaceutical companies. Many healthcare professionals do not bother to report to the FDA, and it is unknown if they report anything to the pharmaceutical companies.

To try to understand the number of deaths caused by blood clots in the lungs, we relied on the VTE rates that the European Medicines Agency (EMA) publishes. In 2014, the EMA circulated a table of VTE rates [3].  This table gives a range for each type of progestin hormone involved in each of the combined hormonal contraceptives.

In the U.S., the FDA allows companies to put a chart on the package inserts listing estimates of venous thromboembolism which are currently estimated at 3-12 events per 10,000 women, but that number is lumped together for all formulations of hormonal contraceptives. By combining the rate of blood clot for each of the different types of hormonal contraceptive, it is impossible to look more deeply at the figures, especially at which hormones might be causing more blood clots. The EMA information allows this type of review.

We also purchased the prescription data from IMS Health and used information from the CDC to determine the number of women in 2013 that used different combination hormonal birth control products. IMS Health is a leading global information and technology services company, providing prescription drug data to a variety of corporations, and groups, including the FDA. The EMA gives a range of VTE rates based on the type of progestin hormone used, illustrated in Table 1.

Table 1: EMA Risk of Developing a Blood Clot.

Table 1- EMA Risk of developing a blood clot (VTE) in a yearBecause the number of deaths while using a combined hormonal contraceptive is unknown, we decided to calculate how many women might die. We used information from the reference book Contraception Technology [3], which says that 66% of women with a VTE will have a deep vein thrombosis and 33% with a VTE will have a pulmonary embolism. They cited a death rate of 6% for women with a DVT, and a death rate of 12% for women with a pulmonary embolism.

Using the data for contraceptive methods published in 2013, which is very similar to the CDC’s 2011 data, we calculated that there were approximately 11,000,000 women using a hormonal contraceptive that contained an estrogen and a progestin. The basic information is shown in Table 2.

Table 2: Comparing VTE Impact (estimated) across 2nd – 4th Generation Combination Hormonal Contraceptives for U.S. Women in 2013.

Table 2 Data Points

Next we calculated the estimated number of women potentially affected with a VTE, DVT, or PE using both the low and high EMA rates. We then calculated an average of these numbers. The estimated average number of deaths in 2013 from a pulmonary embolism is 307 deaths. This does not include deaths from a deep vein thrombosis, stroke, cerebrovascular accident, or hemorrhage or any other cause triggered by a combined hormonal contraceptive. Table 1 looks at the estimated rate of VTEs for different generations of contraceptives while Table 3, shows our calculations for VTEs, DVTs or PEs events [5].

Table 3: Calculations for VTEs based on type of progestin.

Table 3- Comparing Annual VTE rate

Joe Malone recently calculated the number of deaths in another way. He took the number of U.S. births in 2013, published by the National Center for Health Statistics[6], and numbers from a study by A.H. James [7] who stated that “VTE accounts for 1.1 deaths per 100,000 deliveries, or 10% of all maternal deaths.”

Using information from James’ study, Joe calculated that approximately 43 women died because of a VTE in 2013. (See Table 4). This number is far lower than the 307 women we calculated to have died in our analysis of women on combined hormonal contraceptives. The lower number of deaths in James’ study may be due to several factors. For example, James’ study was of deliveries, not pregnancies. The number of deliveries likely is lower than the number of women who become pregnant. Another factor might be that the number of deaths reported on the CDC website of pregnant women includes women who died up to one full year after giving birth, which would result in higher totals.

Table 4: Comparison of VTE Related Deaths – Pregnancy & CHC Use

Table 4 Pregnancy & CHC deathsBy whatever numbers we used, however, the death rate attributed to blood clots was higher in women using hormonal contraceptives than in pregnancy or postpartum. Moreover, the death rate was significantly higher. By continuing to suggest that the risk for blood clots, and indeed, death as a result of those blood clots, is higher in pregnant and postpartum women than in women using hormonal contraceptives, we place the health and well-being of millions of women in danger; and for some, this risk is deadly.

When I think about the fear mongering comment made in regards to an article about hormonal contraceptive safety, I cannot help but wonder if more information were made available, fewer families would experience the loss of a daughter, wife or mother. Understanding the real risks associated with a medication shouldn’t be considered fearmongering, just the opposite. In fact, to elevate the risk of death due to blood clots in pregnancy or postpartum above those of the medication, is not only fear mongering but dangerous.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

References and Resources

  1. Pregnancy Mortality Surveillance System, Centers for Disease Control and Prevention, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. Updated December 23, 2014. http://www.cdc.gov/reproductivehealth/MaternalInfantHealth/PMSS.html/.
  2. Hazell, L. & Shakir, S. A. W. Under-Reporting of Adverse Drug Reactions A Systematic Review. Drug Safety 2006; 29 (5): (pp. 385-396). Retrieved from https://www.eecs.berkeley.edu/~daw/teaching/c79- s13/readings/AdverseDrugReactions.pdf
  3. European Medicines Agency. (2013). Benefits of combined hormonal contraceptives (CHCs) continue to outweigh risks – CHMP endorses PRAC recommendation,. Press Release dated 11/22/2013. Retrieved from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/20 13/11/ news_detail_001969.jsp&mid=WC0b01ac058004d5c1
  4. A. L. Nelson, M.D. & C. Cwiak, M.D., MPH, (2011). Combined Oral Contraceptives (COCs). In Hatcher, R. D., MD, Trussell, J., PhD., Nelson, A. L., M.D., Cates Jr., W., M.D., MPH, Kowal D., M.A., P.A., Policar, & M. S., MD, MPH. Contraception Technology (20th Edition). Chapter 11, (pp.249-275). Bridging the Gap Communications.
  5. Malone, J., West, D. & West, J. (2015) Retrieved from www.birthcontrolsafety.org, http://www.birthcontrolsafety.org/data–references.html and www.Nuvaringtruth.com, http://nuvaringtruth.com/women-injured-or-died-from-combination-hormonal-birth-control-in-2013/
  6. NCH Data Briefs, Number 175, December 2014. Births in the United States, 2013. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db175.pdf
  7. James, A. H. (2009). Venous thromboembolism in pregnancy. Arteriosclerosis, thrombosis,and vascular biology, 29(3), 326-331. Retrieved from http://atvb.ahajournals.org/content/29/3/326.full
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