Ovarian Cancer, Endometrial Cancer, and the Pill

The most popular method of birth control in the United States is the Pill, followed by tubal ligation (permanent sterilization, or getting your tubes tied) and condoms. The Pill is a hormonal method of contraception, while sterilization and condoms are nonhormonal. The distinction between hormonal and nonhormonal methods of birth control are simply that the former contain synthetic versions of human hormones, while the latter do not.


By suppressing ovulation and thinning the uterine lining, the Pill can reduce risk of ovarian and endometrial cancers.


Glands in our bodies, called endocrine glands, produce hormones; additionally, testes and ovaries — which are parts of the human reproductive system — manufacture hormones. Human hormones are powerful chemicals, which do all sorts of jobs, from triggering puberty to helping us extract energy from the foods we eat. So it’s not a huge stretch to wonder if exposure to the hormones present in certain birth control methods — such as the Pill, in addition to the patch, the ring, the shot, the implant, and some types of IUDs — might have unintended effects on the body. Because hormones can play a role in cancer — either in protecting against it or aiding in its development — researchers are very interested to know if the Pill might increase or decrease risk for various types of cancer.

It’s actually a bit tricky to investigate the possible associations between the Pill and various types of cancer. First of all, there are dozens of types of birth control pills, all with different versions of synthetic hormones, at different dosages, and in different proportions to one another. Furthermore, the types of oral contraceptives on the market change over time — today’s birth control pill is not your mother’s birth control pill. Studying “the Pill” as a single entity could obscure differences between brands. Secondly, most cancers tend to develop later in life, many years after someone may have taken oral contraceptives. Researchers need to be careful to control for all the variables that might increase or decrease cancer risk. Continue reading

Contraception Then and Now

When it comes to contraception, one thing is for sure: We’ve come a long way! And while the future might have even better things in store, like reversible male birth control, superior condoms, or remote-controlled implants, a look into the past reveals that modern contraceptors have a bevy of fantastic options to choose from. Unlike couples who had to forgo contraception or obtain birth control from the black market, nowadays Americans wishing to prevent or postpone pregnancy can select from a variety of legal, effective, and increasingly accessible family-planning methods.


While the history of birth control is fascinating, today’s contraception is the very best.


Let’s look at some old-fashioned birth-control methods and see how they stack up to their modern-day counterparts.

Linen and Guts vs. Latex and Polyurethane Condoms

Most people think of female condoms as new inventions, but the first condom recorded in history was made out of a goat’s bladder and inserted into the vagina — way back in 3000 BC. Ancient civilizations, from the Romans to the Egyptians to the Japanese, made penile sheaths and caps with a variety of materials, including linen, leather, lubricated silk paper, intestines, and tortoise shells. Linen and intestines remained popular through the Renaissance era.

A condom, with user manual, 1813. Photo: Matthias Kabel

Charles Goodyear might be most famous for tires, but his discoveries in vulcanizing rubber also led to the development of rubber condoms in the mid-1800s. Unfortunately, the Comstock Act of 1873 outlawed the manufacture and sale of contraception, and condoms were driven into a shadow economy. In the 1880s, New Yorkers might have been lucky to find black-market condoms made from surplus animal intestines, which were manufactured by Julius Schmid, a German immigrant who otherwise specialized in sausage casings — before his business was shut down by the New York Society for the Suppression of Vice. Condoms weren’t legal in the United States until the Crane ruling of 1918, just in time for the 1920 invention of latex, a form of rubber that was much stronger and more elastic — and with a shelf life of five years vs. rubber’s three months. By the 1920s, Schmid was once again on top of the condom game, peddling brands like Sheik, Ramses, and Sphinx.

Condoms made out of intestines are still on the market, sold as lambskin or “natural” condoms. However, they are not recommended for STD protection: Just as intestines need to allow nutrients to enter the body from digesting food, so too are viruses able to pass through condoms made from intestines. (Sperm, on the other hand, are thought to be too big.) These days, latex is the gold-standard material for condoms, while polyurethane can be used by people with latex allergies. Condoms constructed with these modern materials protect users from unintended pregnancy as well as many sexually transmitted infections, such as HIV and chlamydia. Continue reading

Ten Things Your Mother Never Told You About Condoms

holding condomThere are so many claims made about condoms these days that it’s hard to separate fact from fiction. Perhaps you first heard some of these things from your mother, who sat you on her lap one day and calmly demonstrated proper use, with guidelines for when appropriate. Yeah, right. She probably would have spanked you for even mentioning the word. As for your dad, get real.

Like most of us, you probably first heard about condoms in the locker room or from your friends. Or you read something in a magazine or on social media. As a result, your poor head is filled with various myths, rumors, half-truths, and bad jokes, interspersed with a few actual facts. So, herewith are 10 more half-truths or untruths to add to your noggin.

1 Condoms have a high failure rate. According to one website, “18 couples out of 100 who say they use condoms as their primary contraception method will experience an unintended pregnancy in the first 12 months.” Of course, this includes folks out of this same 100 couples who happened not to be using a condom at the time they got pregnant (or during the whole time) — which greatly reduces a condom’s effectiveness — as well as those who were not using the condoms correctly when they got pregnant. (By the way, though this informative website refers to condomology as “the study of condoms,” starting a sentence with “condomologically speaking” is probably not a good idea.) The failure rate decreases substantially, however, when condoms are properly used: “If used correctly every time you have sex, male condoms are 98% effective. This means that two out of 100 women using male condoms as contraception will become pregnant in one year.” Continue reading

“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading

Will St. John’s Wort Affect Birth Control?

Herbal remedies are very popular around the world. Many people prefer them to pharmaceuticals because they believe herbs can elicit positive results without serious side effects. However, plants produce a wide variety of chemicals at varying concentrations, and might have a number of effects on your body, both good and bad. Furthermore, since herbal supplements are not evaluated by the FDA for safety or effectiveness, consumers often don’t have ready access to evidence about herbal products. We can’t even be sure that they contain the ingredients that are listed on the label!


St. John’s wort might decrease the effectiveness of birth control pills, and might be unsafe during pregnancy.


One popular herb is St. John’s wort, or Hypericum perforatum. While the scientific evidence is mixed at best, many people believe that St. John’s wort can be used as an antidepressant. However, people often treat themselves with herbal supplements without guidance from a medical doctor or pharmacist — and without knowing whether or not these herbs are safe to use with any medications they might be taking.

Over the millennia, plants have evolved all sorts of powerful chemicals, such as toxins, to defend themselves against insects and other predators. For this reason, we can’t assume that plants only contain inert chemicals that won’t affect us or interact with the chemicals in other drugs and supplements we use. St. John’s wort, in fact, contains chemicals that interfere with other medications. It has been banned in France, and other countries require or are considering warning labels on St. John’s wort products so consumers can be aware of possible drug interactions. Continue reading

Let’s Talk Contraception: Dispelling Myths About Emergency Contraception

EmergencyContraceptionSince 1998, when the Food and Drug Administration first approved the morning-after pill, there have been controversies about its sale and use. Initially, age restrictions were enforced to regulate its sale, and some hospitals and pharmacies refused to provide it to their patients. After considerable pressure from public and medical groups, emergency contraception (EC) is available for sale to anyone at their local pharmacy, with the exception of ella and the copper IUD, both of which require prescriptions.


Emergency contraception is widely available, easy to use, and safe!


And yet, after almost 20 years of remarkably safe use, there are still myths regarding its safety, actions and use. Let’s look at some of those myths right now!

First, there are misunderstandings regarding EC’s availability:

Myth: EC is hard to get and you need a prescription.

Since 2013, most ECs are available to buy in pharmacies over the counter to anyone, regardless of age or gender. There are two exceptions: If you need ella, another morning-after pill, you do need a prescription, and the copper IUD requires placement by a health care provider.

Myth: There is only one type of EC available.

There are several different pills available, such as Plan B One-Step or generic equivalents. These all contain levonorgestrol, a progesterone hormone that is also in many other contraceptives. Ella contains ulipristal acetate and works effectively and evenly up to five days after unprotected sex. Ella is dispensed with a prescription. The copper IUD also needs a prescription but is the most effective EC when placed within five days of unprotected sex. It is recommended for obese women or women who have had several episodes of unprotected sex, and its contraceptive effect lasts 10 years. Continue reading

Let’s Talk Contraception: New Developments in Contraceptives for Women

Image: Microchips Biotechnology

Image: Microchips Biotechnology

With the availability of an array of birth control methods ranging from pills to patches, from rings to shots, from male condoms to female condoms, and from implants to intrauterine devices, you might think there is no need for further research into contraception. But not all women around the world have access to the choices that many of us reading this article might take for granted. In fact, many have no access to contraceptives at all.


What do you think about a birth control implant that lasts 16 years and can be activated by remote control?


The Bill & Melinda Gates Foundation is leading the charge in the development of new types of contraceptives for women, especially those who live in areas of the world without easy access to modern contraceptives. According to the World Health Organization, 225 million women in developing countries would like to delay or stop childbearing, but are not using any method of contraception. By giving large grants through their foundation, Bill and Melinda Gates are providing the financial backing for contraceptive research and drug development, which will enable women worldwide to take control of their health — and the health of their children.

In 2012, the Gates Foundation granted Microchips Biotech $6.7 million to develop a microchip implant containing the hormone levonorgestrel (which is a hormone in many oral birth control pills). This very small device, which measures only 20 millimeters by 20 millimeters by 7 millimeters, contains an internal battery and a microchip holding tiny reservoirs of the hormone. The device is implanted under the skin of a woman’s buttocks, upper arm, or abdomen. Once implanted, it releases 30 micrograms of levonorgestrel into the body each day when a small electrical charge inside the chip melts an ultra-thin seal around the hormone reservoir to release the daily dose of medication. Continue reading