the pill Archives - Page 4 of 5

Being a Feminist: Hormonal Birth Control Not Required

Published on April 27, 2016

7023 views

Before I get further into dissecting the Nelson Pill Hearings I want to pause and talk about feminism and my intent for this project. The history of the birth control pill and the history of feminism are closely tied, because, of course, if women can control when and/or whether they have children, they have power over their own lives. First-wave feminists knew this. It was Margaret Sanger after all who coined the term “birth control” and conceived (pardon the pun) the idea of the pill in the first place. And so it’s no surprise that the release of the birth control pill in 1960 ushered in the second wave of feminism.

Somewhere, somehow, many people confused the right to choose with blind acceptance of hormonal birth control as “freedom.” These may be the same people who liken questioning the government with being unpatriotic. I suggest that in a democracy it is our most patriotic duty to scrutinize whether our government is acting in the best interest of its people. Likewise, as feminists it is our duty to scrutinize what may or may not be serving women.

The F Words – Feminism and Freedom

Many people believe that having unlimited access to every kind of birth control is the only way to be a feminist and therefore speaking out against the pill or other hormonal birth control is anti-women. Let us consider for a moment the types of birth control that are encouraged, advertised, and prescribed, and with these medications, whose body is being affected? Who will pay if these methods fail? Who has to deal with the side effects? As someone who suffered a stroke while on the birth control pill, I am keenly aware of the price that comes with this “freedom.”

Anti-feminists like to write a lot of articles about how women want to have it all—as if everyone doesn’t want to have it all. That’s not a feminist concept, that’s an American ideal. So, yes, as an American I want to have it all. I want birth control that doesn’t come with the risk of blood clots. I want birth control that isn’t going to kill me, make me fat, give me acne, create mood swings, or lower my libido. Why would I want all the freedom to have sex without getting pregnant with none of the desire to actually have sex?

Why is Birth Control the Sole Responsibility of Women?

Which brings us to the question—where is the pill for men? Still being tested? We hear about this birth control for men every few years, but it has yet to materialize. Is that because it’s being more thoroughly tested than any hormonal birth control they have ever released for women? The original birth control pill was tested on poor women in Puerto Rico who were not even informed that they were part of a study. This article cannot even begin to explore how the fertility of poor and minority women has been systematically targeted and abused in the name of limiting population growth. That’s a whole other topic. And I’ll be explaining the Puerto Rican trials more in future articles but it is important to note that there were only two years between when the research in Puerto Rico began and the birth control pill was approved for use in the United States. Yet every article about birth control for men suggests that many more years of study are required before we’ll every see this as a reality.

But maybe there is no pill for men yet because the side effects have been deemed unacceptable?

At the Nelson Pill Hearings, Dr. Whitelaw, a private physician and early fertility specialist, asked, “How many adult males would be willing to take an oral contraceptive faithfully if they were told that instead of a possible 50-plus adverse side reaction only one remained, that being the possible loss of sex drive and libido?” How many indeed.

But if loss of libido doesn’t scare you, how about the “50-plus adverse side reactions”? Even in 1970, hormonal birth control was linked not just to blood clots (and by extension DVT, PE, and stroke) but also to cancer, infertility, miscarriages, and even diabetes and rheumatoid arthritis. And that’s just the beginning.

However, and this is a big HOWEVER- it is not my goal to demonize the pill or any other hormonal birth control. It is not my goal to unnecessarily scare people. It’s simply my goal to educate about the dangers of these hormones that are over-prescribed and under-researched. Because I’m a feminist, I believe it is a woman’s right to choose. But that choice must be an informed one. Soon I’ll be writing more about how women are informed by looking at risk communication with these and other medicines.

Information or Patronization?

From what I’ve read so far in the hearings, every doctor who has testified has agreed that women need to be better informed of the dangers of hormonal birth control. Except one. Dr. Robert W. Kistner from the Department of Obstetrics and Gynecology Harvard Medical School said, “I don’t believe it is good medical practice with any medication to go through the list of possible complications.” And by way of explanation for this he says that if you tell a woman that headaches are a possible side effect of the birth control pill, then they will get headaches. I wonder if the same can be said for blood clots? It is also interesting to note when Dr. Kistner was asked by the committee if he had ever worked for the pharmaceutical companies, he answered, “Yes, all of them.”

Maybe it’s time for people like Dr. Kistner and Senator Bob Dole, who was also at the Nelson Pill Hearings, to stop being concerned with women’s “emotional reactions” to information about the pill. And give us the full story even though he thinks it may “confuse the women we seek to protect.” Because unlike Bob Dole, I think that women not only can handle the truth about hormonal birth control, but that they deserve it. It’s time to stop allowing corporations and agenda-driven legislation to decide what we can and cannot understand, what we do and don’t need to know about medications that affect us.

Because are women really liberated if we have taken the freedom to choose and handed it to pharmaceutical companies?

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.

A Stroke from Hormonal Birth Control: Part 1

by Kerry Gretchen

Published on March 15, 2016

4397 views

Stroke from hormonal birth control - Kerry Gretchen

I opened my eyes and saw my husband, Josh, holding my hand, looking very serious. He was telling me that we would get through this, that even if I had to learn to walk again, that whatever it took, we would be okay. I remember thinking, “It’s okay, honey. I just have a headache.” We had been married for a year. The next time I opened my eyes Josh was leaning over me. I was on my side in the emergency room and the doctor had just asked him to hold me steady while he gave me a spinal tap to check for meningitis. Josh held me so firmly, terrified by the risks of a misplaced needle, that his arms were shaking from the strain. I tried to tell him, “Don’t worry about holding me. I can’t move anyway.” I had lost the use of my limbs hours before, maybe even days. And now it seemed my power of speech was gone, as well.

The headache had started a month earlier. I remember exactly when because it woke me in the middle of night and I had never had that happen before. We were visiting friends in New York right before Christmas. I got up and took some ibuprofen and didn’t give it much more thought. But it never really went away. I saw a chiropractor. I took more ibuprofen. I checked out a book on meditation. By the time I saw a gynecologist, I also had an unexplainable pain in my left thigh. The gynecologist told me the pain in my leg was probably just a muscle strain and she prescribed Imitrex for the headache, a migraine medication that shrinks the blood vessels in the brain.

The migraine medication made the headache go from dull and persistent to unbearable. I visited a health clinic where the doctor suggested an appointment with a neurologist the following week. That night my left arm started to go numb. I called a local pharmacist who said it might be my birth control pills. That’s crazy, I thought. I’ve been on them for 10 years. I slept on the couch because I couldn’t bear the thought of having to move to the bedroom. The music that had been on the television roared in my head like it had been trapped there on repeat. The next day I called the health center again and they told me to go to the emergency room.

Over the course of the next two days I would take 3 ambulance rides, be sent home from the emergency room twice, begin to lose all control of my body, and be given a very stern lecture by a nurse who thought I needed to learn how to “manage my stress.”

The spinal tap in the emergency room was not the first time Josh had to hold me down. Earlier that day, he tried to restrain me while my body thrashed wildly. During the seizure, I told myself that if I just calmed down, it would stop. It must all be in my head since the doctors said it was just a “tension headache.” We locked eyes, both of us terrified of what was happening to me. When the shaking finally subsided, he asked me if he should call 911. Again. All I could do was nod.

I did not have meningitis. There were blood clots in my brain and because they had not been treated right away, one of the veins in my head had burst and was bleeding. I was having a massive stroke.

Later, Josh would tell me about overhearing the neurologist and the neurosurgeon arguing. The neurologist thought they should operate. The neurosurgeon thought it was too risky. Neither wanted to be there. It was Martin Luther King, Jr. day. (I have since learned never to get sick on a holiday weekend.) In the end, they didn’t operate. I don’t remember exactly when they told me that I had had a stroke. But I know I had no understanding of what that meant. (I find that even now, ten years later, I am still learning.) As far as I knew, that was something that happened to old people. I was 28 years old.

At some point, they told me that I had a clotting disorder and that this genetic anomaly coupled with the hormones in my birth control had caused my stroke. This wouldn’t mean much to me until after I learned how to walk again, do math again, shave my own armpits again.

Not long after I was discharged from the hospital, I had an allergic reaction to the anti-seizure medication. I returned to the emergency room at the request of my neurologist. This time they immediately took me to an examination room. When the doctor walked in, the same doctor who had finally diagnosed my stroke, he said, “I’m so glad to see you. I didn’t think you were going to make it.”

That statement stayed with me throughout my recovery. Because though intellectually I understood that the stroke could have killed me, I never really understood the gravity of the situation until he said that to me. And it made me begin to really consider what happened to me and why.

I was first prescribed birth control pills at the university health clinic my freshman year of college. I wasn’t even sexually active at the time, it just seemed like a rite of passage. Why did no one tell me about the dangers of the pill? I wondered. And why didn’t anyone tell me that I could have a clotting disorder without knowing it? How many other women have this clotting disorder? How many other women have had blood clots? How many have actually died from hormonal birth control? Throughout my recovery, I struggled with these questions. Eventually, I even tried to answer some of these questions with my master’s thesis. For more on my recovery and thesis work, see Part 2 of A Stroke from Hormonal Birth Control.

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.

Why I am Backing Sweetening the Pill, the Documentary

by Laura Wershler

Published on June 29, 2015

3280 views

There are just three days left for the Kickstarter campaign launched by Ricki Lake and Abby Epstein to raise the $100,000 needed to make their next documentary. Inspired by the provocative 2013 book Sweetening the Pill: Or How We Got Hooked on Hormonal Birth Control by Holly Grigg-Spall, Sweetening the Pill, the documentary, aims to fairly critique hormonal birth control and raise awareness of non-hormonal alternatives. Lake and Epstein hope to do for birth control what their acclaimed documentary The Business of Being Born did for birth, get us thinking beyond a one-size-fits-all approach. Currently for contraception, that one-size approach is all about synthetic hormones packaged as—what are now being called—modern contraceptive methods.

Will this film ever get made? I bloody well hope so, and so should the thousands upon thousands of women who have experienced side effects associated with hormonal contraception, from those considered a mere nuisance, to adverse experiences that impair quality of life, to those that threaten a woman’s life itself.

I am not an alarmist, although I do believe that young women dying, however rarely, because they are using hormonal contraception is an unacceptable outcome, especially when safer hormonal and non-hormonal alternatives are available. Women’s health and safety absolutely matter to me, but I want this film to be made so that issues I have been advocating about for 30 years will finally get an accessible, comprehensive public airing.

With that said, here are five take-aways for viewers that I am expecting from the documentary Sweetening the Pill:

1) Hormonal birth control does not, has never, and will never regulate or normalize periods.

There is a false belief held by girls and women of all ages that problem periods are regulated or fixed by taking the Pill. Periods on the Pill are shorter and lighter because they are not real periods. Lara Briden, ND, author of Period Repair Manual: Natural Treatment for Better Hormones and Better Periods, sets the record straight in this June 3rd piece for Hormones Matter: Pill Bleeds are not Periods.

2) Contrary to what women are constantly being told, there are health benefits to consistent ovulatory menstrual cycles. By suppressing ovulation and normal menstrual cycle function we are, over time, depriving ourselves of these benefits.

You won’t get this information from your gynecologist, but you will from endocrinologist Dr. Jerilynn C. Prior, scientific director of The Centre for Menstrual Cycle Research at the University of British Columbia. Prior has over 40 years experience researching the very thing that all hormonal contraception disrupts: ovulation and normal menstrual cycle function. She has written a series of papers on the Preventive Powers of Ovulation and Progesterone that explain the impact of ovulation on our bone, breast and heart health. It is not “incessant menstruation” that’s bad for women’s health, as many OBGYNs would have us believe, but ovulatory disturbances. As I wrote once in a letter to Ms. Magazine challenging the assertion that suppressing ovulation and menstruation is good for our health: “Ask not what those cycle-stopping pills will do to you, but what a healthy ovulatory menstrual cycle can do for you.”

3) The pill should NOT be the standard-of-care treatment for being a girl.

In the foreword I wrote for Grigg-Spall’s book, I noted that: “Prescribing the pill, or other forms of hormonal contraception, has become, in the minds of most health-care providers, the ‘standard of care’ for being a girl.” It’s being used to treat every manner of menstrual cycle problem—irregularity, heavy bleeding, painful periods—associated with the maturation process of an adolescent’s reproductive system. The only sure thing these drugs will do is interrupt this maturation process. Alternative treatments for these problems can be found in the adolescence section on the CeMCOR website. On June 11, 2015, Twitter menstrual cycle advocate Kylie Matthews (@AuntFlo_28) Tweeted me this: “would you believe my 11 year old’s pediatrician already ‘recommended’ I put her on the pill? Of course I know better!” I expect the STP documentary to make sure all mothers know better.

4) Fertility Awareness Methods (FAM) of birth control, taught by skilled educators and enhanced with new technology, qualify as modern contraception.

The mainstream sexual and reproductive health community’s dismissiveness of fertility awareness based methods of birth control and its frustration with women who use or want to use them, must stop. In a previous Hormones Matter piece, I said that women who can’t, won’t, or don’t want to use drug- and devise-based birth control, have the same right to information, support and services as women who are willing and able to use hormonal birth control. Failure of the SRH community to adequately meet the needs of these women is contributing to unplanned pregnancies. But they aren’t the only show in town anymore, and women are seeking out alternative health-care providers, fertility awareness educators, and technological FAM support in droves. The roster of Justisse-trained Holistic Reproductive Health Practitioners is growing world-wide; women can readily access the services of HRHPs like Amy Sedgwick at redtentsisters.com and Ashley Ross at Conscious Birth Control. Tech companies like Kindara and Ovatemp are introducing thousands of women to the scientific principles that underpin fertility awareness methods that are as effective as the Pill at preventing pregnancy. I expect Lake and Epstein’s documentary to leave viewers fully informed as to how women can access the resources and experts they need to learn and use FAM effectively and confidently. If FAM is hot, and it is, then it’s modern contraception.

5) Body literacy, understanding how our bodies work and how hormonal contraception works, must precede birth control decision-making.

Girls deserve to grow up body literate. They must understand how their bodies work and how a normal menstrual cycle unfolds. They must be encouraged to develop a personal relationship with their bodies before they start making decisions, or have decisions made for them, on how to manage their cycles and their fertility. This is a tall order, but if the wave of 20- and 30-something women who are quickly acquiring this foundational knowledge is any indication, it just could be that the next generation of girls will grow up with the life skill of body literacy. They will understand how their sexual, reproductive and general health and well-being are connected to their menstrual cycles. Body literacy supports, if not compels, our fully informed participation in health-care decision making. This is the message I expect Sweetening the Pill to deliver.

So, back to the beginning. There are just three days left to become a backer of Sweetening the Pill, to support the making of a documentary that has the power to change the way we think about our bodies, our health and our birth control. There will always be a place for hormonal contraception, and that’s a good thing. But women need more and better options. We need to know that we don’t need to take it at all if that’s our preference, and that if we do, we don’t need to take it, and probably shouldn’t, for more than a few years of our reproductive lives.

Sweetening the Pill is about the future. Will you be a part of it? To echo my conclusion of the book’s foreword: This film will offer a new perspective on the Pill and its influence on our bodies and our lives, as well as evidence that affirms and confirms we make sacrifices—large and small—to live under its influence. It will remain for viewers to decide what to do about it.

Sweetening the Pill, the Documentary

About the author: Laura Wershler, B.Sc., is a veteran pro-choice sexual and reproductive health advocate and women’s health critic who has worked for or volunteered with Planned-Parenthood-affiliated organizations in Canada since 1986. Laura graduated with a Certificate in Journalism from Mount Royal University in 2011. She has contributed columns on women’s health to Troymedia.com and blogs regularly for re:Cycling, the blog of the Society for Menstrual Cycle Research. Follow her on Twitter @laurawershler.

Participate in Research about Oral Contraceptives

Hormones Matter is conducting an ongoing, online survey of oral contraceptive side effects. If you have ever used oral contraceptives, you are eligible to participate. The survey takes 10-15 minutes and is anonymous. Take the oral contraceptives survey today.

Hormones Matter conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

If you’d like to share your health story contact us here.

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.

Pill Bleeds Are Not Periods

by Lara Briden, ND

Published on June 3, 2015

12023 views

The Pill is not just contraception anymore. It has become standard treatment for everything from acne to endometriosis to irregular periods. Yes, hormonal birth control can mask symptoms, but it cannot “regulate” hormones or periods in any meaningful way.

Hormonal birth control does not augment or regulate hormones. Instead, it suppresses ovarian function and shuts down hormones completely. It replaces endogenous hormones with synthetic steroids, and that’s not good enough for women’s health. Real hormones have many benefits for health that synthetic steroids simply cannot deliver.

Real Hormones versus Synthetic Hormones

Our real endogenous hormones are estradiol and progesterone. In contrast, synthetic steroids are ethinylestradiol, levonorgestrel, drospirenone, and many others. Real hormones and synthetic steroids are similar molecules, but they’re not identical and as a consequence, synthetic steroid have many different effects on the body, some of which we are only now beginning to understand.

For example, estradiol improves insulin sensitivity. Its synthetic counterpart ethinylestradiol impairs insulin sensitivity [1] (which is one of the ways the Pill causes weight gain). Progesterone is beneficial for hair, brain health, and bone density, but its synthetic analogues levonorgestrel, drospirenone, and medroxyprogesterone have quite different effects. They cause hair loss, depression [2], and reduced bone density. Moreover, the drospirenone progestin found in the Yaz, Yasmin and Ocella series of birth control pills, increases the risk of heart attack and stroke six fold. Its modified shape blocks what are called the mineralocorticoid receptors. These receptors are responsible for salt and water balance (think swelling) and blood pressure.

The only way that ethinylestradiol and progestins are similar to real hormones is that they induce a uterine bleed. They can even induce it monthly, but only if they’re dispensed that way.

Why Bleed?

Who really cares about a bleed for its own sake? If women can’t have real hormones, then why have a monthly bleed at all? It is merely to give the appearance of a period, and reassure women that they’ve had a period (when they haven’t). A bleed does prevent excess build-up of the uterine lining, but it does not have to be monthly. It can be quarterly or yearly or any time we withdraw from the synthetic steroids. Regardless of when we choose to bleed, the pill bleed is not the same as menstruation. Remember, the purpose of oral contraceptives is to block ovulation and prevent pregnancy. Without ovulation, our bodies do not produce endogenous hormones. Indeed, as any woman who has gone off of the pill after a long period of usage will tell you, it takes some time for ovulation and hormone production to begin again.

Normalizing our Periods: A Myth

Interestingly, the “regulation” of periods was the Pill’s earliest cover story. When the Pill was first developed, it could not be sold as contraception because contraception was not legal. Instead, the Pill was ostensibly prescribed to “normalize” periods. “Normalize” was a quaint euphemism which really just meant to be “not pregnant” (wink-wink).

Five decades later, and the Pill’s early cover story has now taken hold as a kind of weird counterfeit reality. Doctors readily prescribe oral contraceptives for all manner of female reproductive disorders, the most common of which is to ‘normalize’ the menstrual cycle. What they, and most women, fail to realize is that the monthly bleed precipitated by the withdrawal of synthetic steroids, is not a real period. It is simply a withdrawal bleed.

It’s time to end it. It’s time to bring back real periods.

There Is Another Way

As a naturopathic doctor working in women’s health for twenty years, I want my patients to have real periods. More precisely, I want them to have a follicular phase and make estradiol. I want them to ovulate, so they can then have a luteal phase and make progesterone. In short, I want my patients to make real hormones and to enjoy their many benefits.

There’s another reason I want my patients to have real periods. A healthy, regular period tells me that all is well with her underlying health. If a woman does not have healthy periods, then I keep working with her until she does. We use her period as a helpful, useful marker guiding her health decisions. We think of it as her monthly report card.

It’s not always easy to restore healthy periods, but it can be done. But with a little perseverance, natural treatments such as diet, supplement and herbs work well, and they give women what they deserve: A real period rather than a pharmaceutically induced bleed.

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

Kojima T et al. Insulin sensitivity is decreased in normal women by doses of ethinyl estradiol used in oral contraceptives. Am J Obstet Gynecol. 1993 Dec;169(6):1540-4. PMID: 8267059
Kulkarni J et al. Depression associated with combined oral contraceptives–a pilot study. Aust Fam Physician. 2005 Nov;34(11):990. PMID: 16299641

Can the Pro-Choice Community Embrace a Birth Control Dichotomy?

by Laura Wershler

Published on September 23, 2014

3594 views

In 2004, when I was executive director of Planned Parenthood Alberta, I gave an introductory presentation on fertility awareness for women looking for alternatives to hormonal birth control. One young woman who’d been on Depo-Provera for five years had been recently diagnosed with severe osteopenia. After quitting the drug, she said she realized in retrospect that for those five years she had felt like she was living “under the surface” of her life.

Another told the story of how she had struggled with serious mood issues while on the birth control pill. She would stop taking it, rely on condoms and emergency contraception for a while, then visit her doctor who would urge her to go back on the pill. After a few of cycles of on-off-on, she quit the pill once and for all. She said she decided to “just stop talking to this doctor about birth control.”

I’ve heard scores of stories like these over the past 30 years, and read hundreds more from women commenting on blog posts and online articles. For decades women have stopped using hormonal contraception to improve their health and well-being. Advocating on their behalf has been a major focus of my work as a pro-choice activist.

The Birth Control Dichotomy

I’ve been a pro-choice sexual and reproductive health advocate since I was 15 years old. Today I turn 60, celebrating a 45-year commitment to pro-choice values. But I mark the occasion with frustration and disappointment because the sexual and reproductive health (SRH) community to which I belong has failed to adequately–unreservedly–serve women who won’t, don’t or can’t use hormonal birth control.

I believe that what is keeping them from doing so is failure to acknowledge and embrace the dichotomy that exists within the pro-choice contraceptive framework.

A dichotomy is division of a whole into two mutually exclusive, opposed, or contradictory groups. If pro-choice contraception is the whole, two mutually exclusive groups are:

women who use and like, or want to use hormonal birth control (HBC)
women who use and like, or want to use non-hormonal birth control (NHBC).

Both groups deserve equal attention, support and services to use the birth control methods they decide are right for them. But this is not happening.

Just as we who hold pro-choice values don’t judge or hassle women for the reasons they choose to have abortions, we should not judge or hassle women for the reasons they choose not to use HBC, nor try to deter them. Yet anecdotal evidence abounds that women who want to quit the birth control pill, have their IUDs removed, or learn fertility awareness based methods (FABM) are often actively dissuaded from acting on their choices. It takes extreme self-assurance to do what one young university student told me she did when her doctor questioned why she didn’t want to use HBC. Her response: “My reasons are none of your business.” She said she knew the doctor would try to overcome her objections to the side effects she refused to incur.

I believe that pro-choice sexual health advocates and care providers can and must find a way to do their work effectively within this birth control dichotomy. We must acknowledge the right of women to choose HBC or NHBC depending on which best serves their health and contraceptive needs. And it’s our obligation to help them use their chosen method effectively and confidently, without persuasion or dissuasion.

This is not being done to the standard I believe it should.

Media, social media, and the blogosphere tell us that young women are ditching HBC, but not finding much information or support from their doctors or sexual health clinics for doing so. So why aren’t SRH organizations researching this identifiable “unmet need” or offering workshops on successfully transitioning from HBC to NHBC?

A one-size fits all diaphragm is in the works, and another silicone version is on the market but incredibly hard to find, as is the spermicidal gel required to use with it. So why don’t SRH clinics have programs in place to make them more accessible to women who want them? After all, the diaphragm was the contraceptive of choice for arguably the most influential sexual role model of the last 15 years – Carrie Bradshaw.

Evidence-based medicine proves that pro-choice FABM are as effective as HBC methods, and can be used with condoms to prevent STIs and emergency contraception if indicated, just as for HBC users. So why doesn’t every SRH clinic or organization provide certified FABM training on site or seek collaborative partnerships with certified, secular-based instructors?

Bottom line? The SRH community is failing to fully meet the needs of women who won’t, don’t or can’t use HBC. The current hoopla over LARCs – long-acting reversible contraception including copper and Mirena IUDs and hormonal implants – as the next best birth control “technology” is mere tangent, not solution. Other than the copper IUD, these are still drug-based methods many women want to avoid.

Women who want to use NHBC effectively and confidently, or seek treatments for menstrual cycle problems that do not require hormonal contraceptives, are turning to care providers and information sources outside the SRH community. Is this what we want?

I don’t get it. If I can embrace the birth control dichotomy and retain my pro-choice commitment why can’t other pro-choice health-care professionals, non-profit organizations, and advocates do the same?

My pro-choice values have co-existed for decades with my advocacy for NHBC and menstrual cycle education. But I admit that because of my chosen focus, it is often wrongly assumed that I seek to deny options rather than to increase them, that somehow I cannot possibly be pro-choice.

Successfully using fertility awareness for birth control from age 27 through menopause (See p.4-5) did not keep me from serving 10 years on the board of Planned Parenthood Federation of Canada, or from bringing me back as a current board member of what is now the Canadian Federation for Sexual Health.

Promoting body literacy – acquired by learning to observe, chart and interpret our menstrual cycle events so that we become fully informed participants in health-care decision making – as a life skill that all girls and women should learn, did not keep me from being executive director of Planned Parenthood Alberta. The organization, which became Sexual Health Access Alberta and closed in 2010, distributed educational resources that included the most comprehensive Birth Control Demonstration & Sexual Health Promotion Kit still available for SRH professionals.

Sharing evidence-based medical information about the value of ovulation to women’s health and how to treat menstrual cycle disorders without the use of hormonal contraceptives, did not keep me from writing commentaries in support of abortion rights.

Within the pro-choice sexual and reproductive health community, I’ve chosen to focus on body literacy, menstrual cycle education, and advocacy for increased access to NHBC. At 60, I’m more committed than ever to promote a broader perspective within my community, one that will fully acknowledge and embrace the birth control dichotomy, one that will serve equally, without reservation, the contraceptive needs of all women.

About the Author: Laura Wershler, B.Sc., is a veteran pro-choice sexual and reproductive health advocate and women’s health critic who has worked for or volunteered with Planned-Parenthood-affiliated organizations in Canada since 1986. Laura graduated with a Certificate in Journalism from Mount Royal University in 2011. She has contributed columns on women’s health to Troymedia.com and blogs regularly for re:Cycling, the blog of the Society for Menstrual Cycle Research. Follow her on Twitter @laurawershler.

Participate in Research

Hormones Matter^TM is conducting research on the use patterns and side effects associated with oral contraceptives – the birth control pill. If you have used and/or are currently using oral contraceptives as a birth control option, please take this important, anonymous survey. The Oral Contraceptives Survey.

To take one of our other Real Women. Real Data.^TM surveys, click here.

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Is Biology Destiny? Being Female and Hormonal Birth Control

by Holly Grigg-Spall

Published on September 5, 2013

3059 views

What does it feel like to be female?

Why is discussion of female biology so controversial?

How does “biology is not destiny” thinking and anti-essentialism impact how we think about being female?

In a blog post I wrote some years back titled ‘Beyond Female’ I asked those questions. It would later became the catalyst for my forthcoming book ‘Sweetening the Pill or How We Got Hooked on Hormonal Birth Control.’ Over the years, I had come to realize discussing biology, and specifically female biology, was a very contentious issue mired in the politics of the “biology is not destiny” mantra of mainstream feminism. The notion that biology is not destiny impacts how we view birth control and as such it precludes the very mention of any potential dangers associated with hormonal contraception. What follows here is an excerpt from my book with some additional text specifically for Hormones Matter^TM, where I explore what it means to be female and the role the pill plays in that discussion.

Female Biology is Important

In order for us to be able to honestly and openly discuss that the pill negatively impacts women it must be acknowledged that female biology is important. Such a discussion cannot avoid the claim that female bodies are different from male bodies.

By arguing that a drug changes female biology and negatively impacts mood specifically, it must be admitted that our experience of life is connected to our biology. It is necessarily claimed that who we are is linked to our biology. To say that the ovulatory cycle, a specifically female bodily system, can not be shut down and ignored without serious repercussion, because it is vitally important to women’s health, is to run the risk of inciting the furor of those who feel they have fought long and hard to wrestle down and defeat the connection between women and their bodies. Such statements are controversial. Even using the word ‘female’ can be contentious today.

In regards to the pill, we need to talk about “women” and “femaleness” because this is integral to how and why the pill came to exist and why it is still taken by so many women. To say that the pill can change the way a woman feels by meddling with her biology reads as anti-feminist. It is also anti-feminist to not take women at their word and validate their personal experience by acknowledging it to be right and true.

Marketing the Pill – Beyond Femaleness

Taking the pill might be seen as an act of trying to get beyond femaleness. As femaleness in our culture is understood in the negative, escaping its confines is good and progressive. Any dislike we develop of being female and of having a female body is rooted in the history of female bodies being seen as problematic and in need of male control.

This drug is not just birth control; it is, as a Yaz tagline once explained “beyond birth control.”

Taking these drugs is about being ‘beyond female.’ Female is not good, female is not something you want, female needs to be controlled, influenced, changed and organized into something neater, easier and less frightening to you and those around you. When we take the pill we shut down the interior indicators of our femaleness. The exterior remains and it is this that makes it acceptable. In actuality, the pill makes women more physically attractive within the boundaries of our Western patriarchal capitalist culture. We are free of messy periods, we may have clearer skin, be slimmer, we may have bigger breasts, and we are supposedly rid of troublesome PMS.

The former YazXpress area of Bayer’s promotional Yaz website asked women to ‘Get with the program!’ Women taking or interested in taking Yaz were able to sign up for an “insider’s guide to Yaz, fashion, music and style.” The articles in this guide were co-created by the magazine editors at Elle and Cosmopolitan, the pages of which frequently feature print adverts for birth control brands. Yaz was associated with an affluent, glamorous way of life.

Taking Yaz would lead to the life of an attractive, confident ‘Sex And The City’ type of woman. Coolness, sexiness, modernity and glamor were linked to taking this brand.

In 2009 Bayer took on Lo Bosworth, star of The Hills, a popular Los Angeles-based reality show about a group of twenty-something women aspiring to make it in Hollywood, as a spokeswoman for Yaz in Canada. Of her support for the drug, Bosworth remarked, “As a ‘Gen Yer’ working in the entertainment industry, I need to be disciplined. I need to make sure I’m taking care of myself so nothing interrupts my day.”

Plastic Surgery versus the Pill

Although certain procedures have entered the mainstream in the US, women who have plastic surgery can come up against much criticism. Discussion circles around ideas of women taking plastic surgery choices too far, getting obsessed with making changes, making choices based on their insecurities or in response to difficult experiences such as the failing career and the bad break up. A woman who chooses to undergo plastic surgery is choosing to change her body. She is exerting control over her body. She is choosing to be ‘beyond’ human through changing her very physicality. She is choosing to not age or not submit to what her genes, her biology, have given her.

How does plastic surgery factor under the women’s liberation message of “my body, my choice” and why is so much said about the psychological and social impacts of this choice?

Why are people who have lots of plastic surgery a concern, but not people who take a drug to shut down their ovulatory cycle, stop their periods and ‘perfect’ their bodies from the inside out?

Environmental Estrogens

We are used to seeing labels for “BPA-free” plastics as we have become more aware of the synthetic estrogens in many everyday plastic products. One study shows seventy percent of items made of plastic leach chemicals that act like estrogen.

The perfected body, as our ideology teaches, is not female but male. If we shut down the essential biological center of femaleness, the primary sexual characteristics, then can we say that women on the pill are still “female”? The mythology of the pill reveals how femininity is valued within our society. Women on the pill still have their secondary sexual characteristics. We understand judgment and valuation of our femininity is directly correlated with our appearance, significantly our attractiveness. Women who are not attractive by the Western cultural standards have their femaleness questioned, as do women who have less defined visual secondary sexual characteristics, such as smaller breasts or a wider waistline or shorter legs. The ideal body in this age of plastic surgery has exaggerated exterior signs of femininity.

Legitimate Concerns For Oral Contraceptives

In a piece for the Vice magazine website, porn actress Stoya writes on her experience choosing a birth control method. She admits she feels hormonal contraceptives are the best choice for an actress having sex with men but states, “the pill and I don’t seem to get along well.” After suffering with side effects in her teens Stoya had not considered using the pill again until she began performing in scenes with men. She started taking the latest brand, “Four months into taking Yaz, I was miserable. I bled profusely the whole time. Instead of migraines once or twice a month, I had them multiple times a week. I had intense mood swings and was constantly dizzy. I had planned on giving it another one or two months, hoping that my body would adjust, and then I fainted while waiting in line at the bank.”

She came off Yaz and four years later decided to try Ortho Tricyclen Lo, but only lasted three months. She now takes Loestrin 24 Fe and still experiences continuous bleeding and mood swings but describes how pleased she is with one particular side effect – an increase in the size of her breasts, “Dragging myself out of bed became a herculean effort, and the idea of showering or brushing my teeth was beyond my abilities. Everything felt tragic and hopeless. My only redeeming qualities were my tits. They were by no means giant hooters, but they were noticeably fuller, which was pretty cool. I started to think hormonal birth control was a patriarchal plot to keep women down by rendering us completely loony. The question, “How can we ever break the glass ceiling, if we can’t stop crying?” actually came out of my mouth. I still feel nuts, but hey… at least this B-cup kind of fits.”

Stoya has self-awareness and insight into her situation but she sacrifices her health and well-being partly, it seems, because she’s not aware of the alternatives or feels they are off-limits to her. She wryly jokes about her predicament.

Female Sexuality

A woman on the pill is likely to experience low libido and will certainly feel some detachment from her sexuality. The feeling of sexuality is different from female sexuality, but is vitally important, as it is personal to women and separate from their relationships to men. Not feeling sexual could lead to a desire to look exaggeratedly sexual and to appear and behave very sexually in an act of over-compensation. Such a desire can be fulfilled in part through plastic surgery.

The Blame Game – On Being Hormonal

We support modifying and suppressing our bodily functions with science to perfect our faulty bodies even when we are generally healthy and well, and even when the notion of what it means to be faulty is so spurious. When experiencing the side effects from hormonal contraceptives women have a tendency to blame what they view as their own overly hormonal, unpredictable, difficult bodies that in reacting negatively to these drugs are behaving badly. It is their bodies that are not good enough for the drugs.

Medical Marketing and Birth Control

Even if we are not ill, science is making us better. We are becoming better humans, better women. The pill is no longer about birth control; it is about being a better, improved woman. It is about moving beyond our femaleness, about asserting loudly that biology is not destiny; but should it be?

Pharmaceutical companies move the target constantly from birth control to menstruation suppression, from acne control to mood control and in so doing they are betraying their motivations. By medicalizing the normal physiology of the female body, and saying overtly that it needs to be controlled and improved upon they are betraying the foundations of pill promotion. If we believe we should get beyond our femaleness we are accepting that women’s bodies are bad and need to be made good. The consumer economy is crafty; it will always find an avenue for assimilation. The pharmaceutical companies are listening at the door to our presumed post-feminist talk. What do you think?

About the Author: Holly Grigg-Spall is a writer and activist. Her work has featured in the Washington Post and the UK Times and Independent newspapers. She has contributed to re:Cycling, the F-Bomb, Bedside Manners, Ms. magazine’s blog, and Bitch, amongst others. You can find out more about her forthcoming book ‘Sweetening the Pill’ and documentary project at Sweetening the Pill, on Holly’s Facebook page or by following Holly on twitter: @hollygriggspall.

Participate in Research

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Over the Counter Birth Control Pills

by Chandler Marrs, PhD

Published on December 10, 2012

2971 views

Should birth control pills be available over the counter? In an unexpected and likely controversial position statement, the American College of Obstetrics and Gynecology (ACOG) announced its desire to see birth control pills sold over-the-counter (OTC). Stating that “oral contraceptives are very safe, and data show women can make these decisions for themselves.” Dr. Kavita Nanda who co-wrote ACOG’s paper, suggested that OTC birth control pills could reduce the rate unintended pregnancy significantly and save the nation $11 billion annually.

The bold move from prescription birth control pills to OTC is sure to remove barriers, provided the to-consumer pricing doesn’t skyrocket as is often the case when medications are sold OTC. Given the ongoing politicization of women’s reproductive health, returning the control of women’s health to women’s hands would be a laudable move and might even turn the volume down on current debates.

Imagine if birth control decisions were entirely personal and unhindered by political whims. Consider that greater access to birth control might be the key to reducing unintended or unwanted pregnancies. The availability of OTC birth control pills could be a very positive development for women’s health.

Are Oral Contraceptives Safe Enough to be OTC?

Unlike other over-the-counter medicines like ibuprofen that represent a single compound to be used for specific ailments – pain and inflammation – there are dozens of different birth control pills. Birth control pills are prescribed for an ever-increasing list of female ailments beyond simply preventing pregnancy. The question of whether birth control pills are safe must take into consideration the specific compound, dosage and woman. Some oral contraceptives have better safety profiles than others and some are quite dangerous (See Here).

Within the current market, determining which pill works best for which women, even in the doctor’s office, is a trial-and-error process. Much of the medication safety information is provided through the marketing channels of the product manufactures and–as has been reported here–those data are frequently biased and sometimes fraudulent. In that light, letting women self-select the appropriate birth control pill may be no worse than the current sub-optimal process.

Over-the-Counter Birth Control in Other Countries

In other countries where for-prescription regulations are not enforced, oral contraceptives and other medications may be purchased over the counter already. Numerous studies suggest women are capable of self-screening for the contraindications or risk factors associated oral contraceptives. This supports the argument that women can manage their own oral contraceptive use, at least for its intended purpose of preventing pregnancy. Whether women would continue to utilize oral contraceptives for the myriad of other conditions for which these pills are currently prescribed, remains unclear.

Though no data exists for oral contraceptive usage, ease of access to non-prescription medication shows a direct relationship to the use and abuse of prescription medications and mortality by overdose. That is, countries with strictly enforced prescription drug laws (the US, Canada) have higher prescription use rates and higher mortality from overdose with no concomitant decrease in morbidity or mortality by disease or really any overall improvement in health. These data suggest that as prescription requirements loosen, use of more potent medications decreases. In the case of oral contraceptives, it is possible that OTC access could reduce the current trend of utilizing oral contraceptives as the magic pill that treats all reproductive disorders. This could be good thing for women, but it may not be a good thing for industry.

The Economics of Birth Control

Social and political benefits aside, women’s reproductive health is a market. Unlike other markets affected negatively by the economic downturn, the birth control market appears untouched, even bolstered. Sales of oral contraceptives are expected to reach $17.2 billion worldwide within the next few years. As one of the most commonly (over)prescribed medications in women’s health, oral contraceptives are used as a first line of treatment for a range of conditions unrelated to birth control. One has to wonder why the organization that controls access to this medication in the US would want to lose such a lucrative cash cow.

For millions of healthy women, the annual exam to renew one’s birth control prescription is the only reason to visit a physician. For the millions of other women with endometriosis, PCOS, PMS, and a host of other common conditions, oral contraceptives remain the first and sometimes only line of treatment. Selling oral contraceptives OTC would effectively remove those business segments from the gynecologist’s bottom line. When combined with other market segment encroachments on the business of obstetrics and gynecology (midwifery for healthy birth and maternal-fetal medicine for complicated birth), from a purely economic and albeit cynical standpoint, it is perplexing that that this organization would give away the largest remaining revenue stream of its members.

The economic drivers from the pharmaceutical industry’s perspective are no less perplexing. If priced correctly, over the counter oral contraceptives could increase sales–especially to lower income women who were previously locked out of the market by lack of insurance or access to healthcare providers. However, OTC access might also reduce the growing percentage of ‘off-label’ uses. For an industry unaccustomed to R&D in this sector, (why develop specialized therapeutics for the array of women’s health conditions, when birth control pills can be prescribed for all), the move to OTC could have serious financial ramifications.

There must an economic upside for these organizations, but for the life of me, I cannot figure it out.

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.

The History of Birth Control and Eugenics

by Lisbeth Prifogle, MFA

Published on July 10, 2012

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I’m a 30-year-old woman in a long-term relationship. If I had a dollar for every time someone made the comment, “If you wait until you’re ready to have a baby, you’ll never have one,” I could retire. This statement is an oxymoron to our behavior as a species, because we have been trying to control family planning as early as 1550 B.C. The first known contraception attempt was found in an Egyptian manuscript called the Ebers Papyrus. It directs women on how to mix dates, acacia and honey into a paste, smear it over wool and use it as a pessary, a medical device inserted into the vagina and held in place by the pelvic floor musculature, to prevent conception.

Today, hormonal contraception is used by 98 percent of women at some point in their lifetimes. Politicians and religious leaders still battle the rights and responsibilities of family planning in 2012. Even more controversial than the current reproductive legislation is the history of the little pill that changed the world. I don’t want children (if I ever find myself at the doors of motherhood it will be purely by accident), I can’t take hormonal birth control, and I think the battles over birth controls and abortions are simply ridiculous (it’s 2012 and this is what we have to fight in the ‘modern’ world?); however, as a woman it is important to understand the history of how modern birth control was conceived.

Contraception

From the Egyptians, contraception evolved from sheep-bladder condoms, to lemons cut in half and used as a cervical cap, to chastity belts, to the various products we have today. In a previous article, I wrote about the various hormonal and non-hormonal birth controls for men on the market or in the research phase. But, more than the interesting inventions for contraception worldwide (check out Time Magazine’s timeline of birth control here), I’d like to look specifically at the long battle for birth control in America.

Comstock Act

As a libertarian, I believe that society could run more efficiently without many of the ridiculous laws that pass through legislation. History and current legislation show that our politicians and leaders think the opposite. In 1873, in an attempt to regulate morality in this country, the Comstock Act was passed. The “Act for the Suppression of Trade in, and Circulation of, Obscene Literature and Articles for Immoral Use,” banned everything from obscene literature, to birth control and abortion devices. Doctors could not even pass on information about sexually transmitted diseases.

Margaret Sanger

Margaret Sanger was a nurse who saw women suffer and die from unwanted pregnancies. Her own mother had 18 pregnancies, 11 children and died at the age of 40. Sanger worked in New York’s Lower East Side with immigrant and lower class women who often died from complications from unwanted pregnancies and illegal abortions. She opened up the first birth control clinic in 1916 passing out diaphragms, condoms and literature on STD’s and birth control. Nine days later she was arrested and charged under the Comstock Laws. Sanger appealed the conviction, but lost; however, the New York appellate court gave doctors the right to hand out contraceptive information, if prescribed for medical reasons. In 1921, she founded the American Birth Control League, which later became Planned Parenthood. These two organizations later merged and became what we now know as Planned Parenthood.

In 1936, Sanger helped bring the case of United States v. One Package to the U.S. Circuit Court of Appeals which allowed physicians to legally mail birth control devices and information throughout the country. Yet, it wasn’t until 1965, in the Supreme Court case of Griswold v. Connecticut, that the private use of contraceptives was deemed a constitutional right.

In her lifetime Sanger published various magazines and pamphlets about birth control. She traveled through Europe and Asia promoting and helping develop spermicidal jellies, foam, powders and hormonal contraceptives. It wasn’t until 1950 that the first oral contraceptive, AKA the pill, was developed.

Birth Control and Eugenics

Sir Francis Galton, the cousin and disciple of Charles Darwin, is the father of the applied science of eugenics. One the goals of eugenics was to encourage people of above average intelligence and physical capabilities to breed in order to make an improved human race. The offshoot was racism, classism and discrimination against physically/mentally handicapped.

An often hidden and/or denied history of Margaret Sanger is her beliefs and practice of eugenics. Prior to Hitler’s attempt to create a ‘master race’ there was a strong eugenics movement in America. As many as fifteen states had eugenics laws on the books by 1924, but Virginia was the only state to rigidly enforce the marriage laws prohibiting interracial marriages with the Racial Integrity Act of 1924. Also popular amongst the eugenics movement was forced sterilization. By 1956, twenty-four states had laws providing for involuntary sterilization on their books. These states collectively reported having forcibly sterilized 59,000 people over the preceding 50 years.

How does this tie into birth control and Margaret Sanger? In a lot of her writing she refers to the Eugenics movement. In one of the issues of Birth Control Review she writes, “Birth Control is not merely of eugenic value, but is practically identical in ideal with the aims of Eugenics.” (The article titled “The Eugenic Value of Birth Control Propaganda” can be viewed here). She did not deny or hide her ties to eugenics practices, yet history often overlooks this fact. Even Planned Parenthood glosses over the issue and simply states, “Her views on eugenics and racial issues remain a subject of bitter debate to this day.”

While birth control has allowed women and men to have control over their reproduction rights and responsibilities, and Margaret Sanger has opened many doors for women, it is important to understand the history of why it was developed. An often overlooked piece of American History is that Hitler actually took his ideas for genocide and creating a master race from the American Eugenics movement. A majority of the states had sterilization and marriage laws that weren’t overturned until the 1950’s and 60’s. Don’t get me wrong, I’m ecstatic that we have condoms, birth control pills, and other forms of protection from unplanned pregnancies and STDs. I’m also glad that we have the right to these medications, devices, and basic information without a ridiculous law on morality, but with our ability to genetically modify children, I wonder how long it will be until a new and modern eugenics movement starts to develop; especially since we often overlook this snippet of American history.

the pill - Page 4

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References

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The Birth Control Dichotomy

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Female Biology is Important

Marketing the Pill – Beyond Femaleness

Plastic Surgery versus the Pill

Environmental Estrogens

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Female Sexuality

The Blame Game – On Being Hormonal

Medical Marketing and Birth Control

Participate in Research

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Are Oral Contraceptives Safe Enough to be OTC?

Over-the-Counter Birth Control in Other Countries

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Contraception

Comstock Act

Margaret Sanger

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