The History of the Birth Control Pill, Part 5: Clinical Trials

Gregory Pincus, Min-Chueh Chang, and John Rock, three scientists employed by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Gregory Pincus, Min-Chueh Chang, and John Rock were hired by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Welcome to the fifth installment of our series chronicling the history of the birth control pill. In the previous installment, Margaret Sanger and Katharine McCormick envisioned and bankrolled the development of the birth control pill. Now it had to be tested in large-scale trials.

John Rock, Gregory Pincus, and Min-Chueh Chang had collaborated in the Pill’s development; now it was time to conduct clinical trials. The first study observed 60 women, some of whom were infertility patients while others were nurses. These small trials involved daily temperature readings, vaginal smears, and urine samples, as well as monthly endometrial biopsies. Although the initial results seemed promising, the sample size was small and few of the subjects complied with the protocol.

The approval of the Pill in 1960 marked a turning point in our history.

More test subjects were needed. At this point, historians’ accounts differ. Elaine Tyler May claims that, unable to locate an acceptable pool of volunteers, the researchers tested the Pill on subjects who could not give their consent, such as psychiatric patients. According to Bernard Asbell, however, Rock was scrupulous when it came to informed consent, despite it not being a legal requirement — or even much of a concept at all at this time in history.

Willing participants notwithstanding, conducting such trials in the United States posed a challenge, due to laws against contraception. So the first large-scale clinical trials were conducted in Puerto Rico in 1956. Puerto Rico was densely populated and there was a high demand for alternatives to permanent sterilization, which was widespread on the island due to funding from a wealthy eugenicist named Clarence Gamble, who advocated sterilization for the world’s poor. The clinical trials in Puerto Rico were conducted by Drs. Edris Rice-Wray and Adaline Sattherthwaite; the brand of birth control pill tested was named Enovid. Volunteers were so easy to come by that some clinics had waiting lists. Continue reading

Can Herpes Be Cured Naturally?

Many of us are infected with herpes simplex virus, which can be transmitted sexually to cause genital herpes. Although herpes is incurable, there are antivirals that can help reduce symptoms. But, because not everyone wants to take pharmaceuticals, a lot of us might seek alternatives in an attempt to treat or even cure our herpes infections.

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

For centuries, we have treated herpes in many ways — though not necessarily successfully! In the early 1800s, a British treatment involved placing lint between the tip of the penis and the foreskin. It was claimed that this would cause herpes lesions to heal within 14 days — not coincidentally, this is about how long it takes for them to heal on their own, untreated. Later that century, a London surgeon promoted an arsenic-based solution as a cure for recurrent herpes outbreaks. He presented the cases of a couple of patients. One had been suffering from outbreaks for six years, and after a course of this treatment he allegedly never experienced them again. Another patient had been experiencing recurring outbreaks for four years, and after taking this treatment for a year, his outbreaks “became less and finally cleared altogether.”

We now know that, even without treatment, herpes outbreaks generally become less severe over time, and often stop flaring up completely. When outbreaks do occur, they clear on their own, without treatment. This phenomenon is called “regression to the mean,” and many promoters of bogus remedies rely on it for the appearance that their products work. Because we often think that two things that happen at the same time are related, and that one causes the other, we might attribute the clearing of our herpes lesions to whatever “treatment” we were taking, regardless of whether or not it actually benefited us.

The only way we can know if treatments actually work is to compare them with standard medications or placebos (such as identical-looking sugar pills) in well-designed clinical trials. In such studies, patients are assigned to either medication or placebo at random, which is called “randomization” and is like flipping a coin. And, to protect against introducing bias into the study’s outcomes, trials should be “double-blinded,” meaning that neither researchers nor patients know whether the placebo or the medication under study is being administered. The “miracle cures” you hear about usually haven’t been subjected to such scientific rigor — if they have, the results usually aren’t promising. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 9: Treating Urinary Tract Infections

Urinary tract infections occur when certain bacteria invade the urethra.

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

A urinary tract infection (UTI) affects the urinary system, most notably the urethra. Symptoms might include an increased urge to urinate, accompanied by a burning sensation; urine might be cloudy or bloody. Among adults, UTIs are 50 times more common in people with vaginas than in people with penises, probably due to the shorter distance bacteria travel from the bowel. If you have a vagina, there is more than a 50 percent chance that you’ll have at least one UTI in your lifetime. And, if you’re unlucky enough to be in this group, there’s a 20 percent chance that you’ll develop recurrent UTIs (three or more infections yearly). Annually, UTIs prompt an estimated 8 million visits to health-care providers, costing at least $1 billion.

How can urinary tract infections be prevented?

Although symptoms often recede without medical intervention, it’s important to seek treatment for persistent UTIs because the infection could spread. If you are or have been sexually active, it is also important to ensure you don’t actually have a sexually transmitted disease.

Causes of UTIs

When certain species of fecal bacteria wend their way from the bowel into your urethra, they might initiate an infection. Up to 90 percent of UTIs are caused by certain strains of Escherichia coli; the rest are caused by Staphylococcus saprophyticus, Proteus mirabilis, Klebsiella pneumoniae, and a few other species. Continue reading

Can Cranberry Juice Cure Urinary Tract Infections?

Cranberry products have a reputation for fighting urinary tract infections. But is this reputation deserved? Image: FreeDigitalPhotos

An increased urge to urinate. A burning sensation when you do. These are two of the signs of a urinary tract infection (UTI), an incredibly unpleasant condition that can seem to come out of nowhere. Anyone can get a UTI, but among adults they are about 50 times more common in females than in males. Certain microorganisms cause these infections, often when bacteria from feces are introduced into the urinary tract. Although symptoms often clear up without medical intervention, it is very important to seek treatment for a persistent UTI because the infection could spread and become much more serious. (If you are or have been sexually active, it is also important to make sure you don’t actually have a sexually transmitted infection.)

Cranberry products — either as juice (sweetened, unsweetened, or blended with other fruit juices) or capsules — are considered by many to be an effective home remedy for UTIs. While cranberries are a well-known and accessible treatment, the evidence for their efficacy is not very strong. Why, then, are they such a popular treatment? It could be due simply to the placebo effect, an amazing phenomenon in which our expectations help shape our experiences. It could be that symptoms often clear up on their own, but we attribute our improvement to whatever remedies we happened to be trying at the time. It could be that drinking extra fluids (e.g., cranberry juice) helps flush the bacteria from our bodies as we urinate more. Or, it’s possible that cranberries do help clear up UTIs, but we just don’t have solid evidence yet. Continue reading