Tag Archives: hormonal contraception

Why Periods? False Hopes, Popes, and the “Grandfathered” Withdrawal Bleed

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The birth control pill and other hormonal contraception are popular. Menstrual periods are not. Hormonal contraception can be used to suppress menstruation — so why isn’t this method, called “continuous contraception,” more popular?

For decades, packets of birth control pills have typically contained 21 “active” pills and seven “placebo” pills. These placebos — sugar pills — trigger bleeding (which most people think of as a menstrual period, even though it’s technically called a withdrawal bleed). Because menstruation is natural, some people think this withdrawal bleed must somehow be healthier. But there are actually no health benefits — and it might also increase risk for pregnancy.

There is no reason to have a period when on the birth control pill — unless you want one.

Last month, British medical guidelines were revised to recommend continuous use of the birth control pill — that is, with no week-long “break” designed to trigger a withdrawal bleed. We could have been skipping our periods since the Pill was introduced in 1960 — so why is it only now that we are coming to see them as optional?

A flurry of recent articles has touted a rather conspiratorial claim: that the monthly bleed was included in an attempt to make the Pill more palatable to the pope. The Telegraph quoted reproductive health expert John Guillebaud: “John Rock devised [the week of placebo pills] because he hoped that the pope would accept the Pill and make it acceptable for Catholics to use. Rock thought if it did imitate the natural cycle then the pope would accept it.”

Many journalists, pundits, and bloggers have expressed outrage that we’ve been putting up with decades of unnecessary bleeding (and all the attendant pain, headaches, and missed work) just because of an unsuccessful attempt to appease the pope before most women of reproductive age were even born. But the history of the placebo week is more complicated. Continue reading →

Do Birth Control Pills Cause Breast Cancer? The Latest Study

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Last month, you might have seen headlines warning you that hormonal birth control increases risk for breast cancer. This news came from a study that examined the medical records of nearly 1.8 million Danish women — and the huge sample size lent heft to the findings, several of which stood in stark contradiction to commonly held beliefs about modern hormonal contraception.

Some types of hormonal contraception could increase breast cancer risk, while others may not. But the Pill also reduces risk for endometrial and ovarian cancers.

Birth control comes in two “flavors” — hormonal and nonhormonal. Hormonal contraception is among the most effective, and includes birth control pills, hormonal IUDs, the shot, the vaginal ring, the implant, and the patch. Nonhormonal contraception ranges from very effective, including surgical sterilization and the copper IUD, to the not-quite-as-effective, including condoms, diaphragms, and withdrawal. (With the exception of condoms, birth control does not provide protection against STDs.)

Hormonal contraception is one of the greatest achievements in the history of medicine, and offers those wishing to control their fertility an array of effective options. However, as with all effective medications, there is potential for side effects. And, because many forms of hormonal birth control contain types of estrogen, and exposure to estrogen is a risk factor for breast cancer, many people wonder if hormonal birth control might increase users’ chances of developing breast cancer later in life.

Most birth control pills contain a combination of two hormones: estrogen and progestin (synthetic progesterone). Other hormonal methods, such as the ring and the patch, also use combinations of these two hormones.

There are also pills that don’t contain estrogen, called POPs, or progestin-only pills — aka the “minipill.” Additionally, hormonal IUDs, the implant, and the shot are progestin-only methods.

What Previous Studies Have Shown

The connection between hormonal contraception and breast cancer is murky, because the association is difficult to study properly. There are so many different types of hormonal contraceptives, each with different dosages, different chemical formulations, and different ways of entering the body. We can’t tease these differences apart on the one hand, but make blanket statements about hormonal contraception as a whole on the other hand. But we can look at the available evidence and see where it points. Continue reading →

Pro-Choice Friday News Rundown

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  • I love to start the rundowns off with happy news, and the departure of an anti-choice zealot from office is always a happy occasion!

    When news broke last week that AZ Rep. Trent Franks was resigning from Congress, it sent shock waves through the state of Arizona. To hear that he had reportedly been hounding female members of his staff to serve as pregnancy surrogates for him and his wife was stunning for many reasons:

    1. Ewwwww, this is your boss asking you to have his baby. ACK! NOT NORMAL! AND GROSS!

    2. Surrogacy contracts are illegal in Arizona.

    3. Trent Franks is “pro-life” and surrogacy is almost surely not in line with “pro-life ideals.”

  • All of that aside, we should mark the demise of this horrible man by reminding you all of just how terrible he truly was. The one instance that sticks out most in my mind? When he said that more black babies are “devastated” by abortion than slavery. What a repulsive, malicious, and sickening thing to suggest. That blacks are better off suffering through a lifetime of brutality, torture, and subjugation than never having been born. Adios, Trent, you will NOT BE MISSED, fella! (Rewire)
  • We think this is great news, but for some reason, the teen abortion rate dropping in Colorado by 64 percent isn’t causing jubilation among the anti-choice crowd. Anyone else find that weird? (HuffPo)
  • I don’t know about you, Dear Readers, but yesterday’s plea from that creepy little GOP weasel, Paul Ryan, for Americans to “have more babies” for economic reasons REALLY ticked me off.

    This rich pipsqueak (who whines incessantly about people sometimes needing to draw upon government “entitlements”) sits in total opposition to EVERY policy that would entice people to have more children: universal health care, free or low-cost access to higher education, better funding for public schools, paid family leave, extended social services, a livable minimum wage for all, subsidized childcare, etc. … He and his Republican cohorts are literally opposed to ALL of that which makes having a family less insurmountable.

    It’s hypocritical and callous to try to shame people into having “more babies” when he and his party go to extreme lengths to ensure people have NO financial safety net or governmental aid to rely on when they need it. Let’s hope the rumors of this jerk leaving the Senate in 2018 are true. Maybe he can find it in his icy heart to fund the Children’s Health Insurance Program before he goes. It’s in danger of leaving millions of children without insurance otherwise. I mean, come on. The health of all the babies he wants us to have has to matter to him, right? (Splinter News)
  • There have been a lot of headlines lately about the correlation between birth control pills and cancer. But left out of many of these news stories is the fact that hormonal birth control can also protect against certain cancers. Like everything, have conversations with actual medical professionals to figure out what’s best for you! (NY Times)
  • There may be hope that 45’s attempts to overturn Obamacare’s birth control mandate will fail! (Reuters)
  • As an Ohio native, I must say I’m horrified at how virulently anti-choice the state seems to have become in the 12 years since I left. Currently, a bill is headed to the governor’s desk that would ban abortion in the event a fetus is diagnosed with Down syndrome. Doctors who perform an abortion while aware of the diagnosis would lose their medical licenses in the state and face a fourth-degree felony charge. Is there any chance that maybe the men behind this bill are parents or adoptive parents of children with Down syndrome? I’m guessing no, but it’s nice to know they value the lives of these children. We can only hope that since they are taking families’ choices away, they will somehow provide meaningful support each time one is born rather than adopted. (Scientific American)
  • Remember how all the lying liars in the GOP claimed that they could defund Planned Parenthood and  “community health centers” could easily absorb our clientele and do our work better than us? Welp, the lie detector determined that was a lie. Planned Parenthood will have to start taking on more patients in a suburb near St. Louis because St. Charles County will no longer offer treatment and exams for sexually transmitted diseases through its public health department. And mind you, this is despite increasing STD rates in that county. Unfortunately, the county’s clinic is closing now and re-opening in 2018 with a reorganized clinic model “formulated to reduce expenditures and generate opportunities to increase revenues …” So basically, STD testing and treatment, while a public good, hasn’t been good for their bank account so they’re giving the job to us. Planned Parenthood is here and ready for you STL folks. (STL Today)
  • And lastly, I just want to shout out to my peers and fellow black women in Alabama. They turned OUT in the special election this week and helped Democrat Doug Jones win a seat in the Senate! To quote Cosmo, “White women preferred the accused child molester.” And I have nothing further to add. (Cosmopolitan)

Celebrating Mexico’s Contributions to the Birth Control Pill

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September 15 to October 15 is National Hispanic Heritage Month. We’re celebrating by shining the spotlight on Mexico’s role in developing the birth control pill, one of the most important medical breakthroughs of the 20th century.

Humanity cannot fully unlock its potential until we release the bonds of oppression from all marginalized groups.

Underneath the surface of a large swath of Southern Mexico’s jungles lay the enormous roots of a wild yam, Dioscorea composita, known locally as barbasco. Mostly it was considered a nuisance, as it could get in the way of subsistence agriculture, but it did have its uses in traditional medicine — and it would change history forever when scientists figured out how to wrest valuable chemical compounds from it, a discovery that led directly to the development of the birth control pill.

Russell Marker. Image: Penn State University ArchivesIn the 1940s, hormones held an untapped potential for research, but there was no cost-effective method of producing large quantities of them — including progesterone, the Pill’s essential ingredient. An American chemist named Russell Marker set out to find a way to synthesize progesterone in abundance, hypothesizing that plants from the genus Dioscorea, which includes yams and agaves, would be a good source for starting material. After some research, he set his sights on wild-growing yams that were found only in Mexico.

Marker’s hunch brought him south of the U.S. border, where locals helped him find and gather these yams, enabling him to develop a method for synthesizing large batches of progesterone — more than had ever been in one place. When pharmaceutical companies would not invest in further research in Mexico, Marker relocated to Mexico City and put his money where his mouth was. In January 1944, he co-founded a lab named Syntex — a portmanteau of “synthesis” and “Mexico” — devoted to finagling hormones from wild Mexican yams. That yam was called barbasco by the indigenous population, and it was the industry’s choice for the raw material in hormone synthesis. Continue reading →

Ovarian Cancer, Endometrial Cancer, and the Pill

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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 →

Will St. John’s Wort Affect Birth Control?

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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 →

What Do We Know About Herbal Remedies and Menstrual Cramps? (Spoiler Alert: Not Much.)

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herbalWhen I was entering adulthood and suffering from severe menstrual cramps, I suffered without relief for far too long. And I am certainly not alone in this experience. The most common gynecological disorder is dysmenorrhea — painful menstrual cramps — which strikes an estimated 90 percent of reproductive-age females. Furthermore, around 40 percent of American women use some form of complementary and alternative medicine, or CAM. “CAM” is a catchall for approaches to health care that fall outside of the mainstream. Given the popularity of CAM and the ubiquity of dysmenorrhea, it was no surprise that I experienced painful cramps, nor was it shocking that I tried a few herbal remedies, which are a type of CAM.

“Natural” doesn’t necessarily mean safe or effective, so be critical.

During my second year of college, at the age of 19, a friend recommended a couple of herbal remedies to add to my cramp-fighting arsenal. I tried them, but it was difficult to know if they really worked. My pain varied so wildly cycle to cycle that I had no way of knowing if I was just having a “good month” when I initially tried these products. Although I thought they worked at first, after I had accumulated more menstrual cycles under my belt, I started to wonder if my cramps were really any less painful. On average, I still seemed to be missing just as much school and work as before — but I wasn’t sure.

The problem was that I never collected any before-and-after data — I didn’t spend years ranking the severity and duration of my cramps, or keeping track of the hours spent in bed away from school, work, or other obligations. Furthermore, my initial sense of optimism could have colored my perceptions. Since we can be tricked by our own expectations and biases, it is important to have access to quality evidence — gathered in large, methodologically powerful studies.

Raspberry leaf tea was the first herbal remedy I tried. It tasted OK, and the ritualistic nature of drinking a hot beverage from a steaming mug was soothing. But is there any actual evidence that raspberry leaf can help relieve the pain of dysmenorrhea? Although it’s been used therapeutically since at least the 1500s, the only human studies I can find for any gynecological condition examine its use during pregnancy or labor — not for treating menstrual cramps. The only claims for raspberry leaf’s efficacy in treating cramps come from biased sources, like the manufacturers themselves. It seems the tea I drank during my late teen years had word of mouth and marketing going for it, but not much else. Continue reading →