This year marks the 50th anniversary of the birth control pill, a development that ushered in the sexual revolution of the 1960s and gave women unprecedented freedom to explore their sexuality without having to worry about pregnancy. Because of its convenience, the pill remains the most popular method of birth control in the United States. It also fits well with society's view of the female body as something that requires outside control.
Though there are other reliable methods of contraception, birth control pills have been "pushed" by the medical profession as the optimal method of contraception for the last half century. Other methods, for example diaphragms, condoms and fertility awareness, have been actively downplayed even though, when used properly, they are nearly as effective as the pill. These other methods require more education about the body and more active participation than the pill. They are not geared to the average busy doctor's schedule.
Many physicians also feel that women will not use barrier methods of contraception, such as diaphragms, condoms, or fertility awareness because they have seen too many "failures." This is true of some women but not all women. The data show that in the women who are ideal users--who use the method correctly every time--barrier methods and even "fertility awareness" (natural family planning) can be 95 to 98 percent effective. [1]
Optimal use of contraception other than the pill (or an IUD) also requires women to interact consciously with their fertility--and, ideally, to engage their sexual partners in this awareness as well. The reality is that many women still don't have conscious dominion over their fertility, don't appreciate their fertility cycles and aren't in partnerships that respect these cycles either. The pill (and now the patch) is, therefore, an ideal solution for many. We can use it to manipulate our menstrual cycles, avoiding periods altogether or on weekends. In short, it fits our cultural ideal.
The pill is the most-studied medication in history. Unfortunately, because it's made from synthetic non-bioidentical hormones, it has more side effects than it should! Though we have the science and technology to make safer oral contraceptives (OCs) from bioidentical hormones, there is no profit in doing so--and therefore no support for it. None are currently available.
Is the Pill Right for You?
In order to choose the right birth control method for you, you need to decide honestly where you are in your own life--and how much responsibility you are willing to assume over your fertility. Some women don't even want to think about getting to know their times of ovulation and checking their cervical mucus, let alone inserting a diaphragm before each intercourse. That's fine--they often do well on the pill or another "automatic" method. Other women prefer barrier methods, such as diaphragms and I encourage these methods, too--but only in those women who are committed to using them consciously.
When I was practicing, I worked repeatedly with women who had three or four abortions from failure to use so-called unnatural contraceptives; the pill would have been a better choice for these women, given their sexual behavior. But they refused to put anything "unnatural" in their bodies. I counseled that there is nothing natural about abortion when a woman fails to use her "natural" method of birth control conscientiously.
These women, though conscious about food and the environment, often suffer from the mind/body split we've all inherited. They believe that part of being a desirable woman is to be available sexually, without asking their partners to share in the responsibility. This is a shame, particularly given that there are so many ways to express oneself sexually without the risk of unintended pregnancy. I recommend that all women make every effort to put their own sexual and fertility needs first in every relationship. Doing so takes courage and support.
Pill and Sexual Dysfunction
Ironically, research shows that oral contraceptives might actually contribute to long-term sexual dysfunction in some women. The January 2006 issue of The Journal of Sexual Medicine reports that the pill lowers levels of testosterone, even after the women have stopped taking oral contraceptives. Such problems occur because pill users have elevated levels of a protein called sex hormone binding globulin (SHBG) that binds testosterone, rendering it unavailable for use by the body.
Low values of "unbound" testosterone potentially lead to side effects such as decreased desire, arousal and lubrication and increased sexual pain. Although some research showed that such problems persisted even after the pill was discontinued, long-term studies are still needed to determine if the problems are permanent. [2] Of all the side effects, what concerns me the most is the potential adverse long-term effect on libido.
Health Risks and Benefits
All women who are on the pill (or the patch) should know about the following effects of the pill, too, in order to be fully informed:
• Oral contraceptives have been a boon for many women, though they may contribute to suboptimal nutrition and an increased incidence of yeast infection in many (the pill has been associated with lowered serum levels of B vitamins and other metabolic changes). [3]
• OCs are associated with a slightly increased risk for cervical adenocarcinoma [4], elevated triglyceride levels [5] and systemic lupus erythematosus (SLE). [6] Although the announcement didn't get much press in the U.S., the World Health Organization has classified birth control pills with combined estrogen and progestin (as well as combined-hormone HRT) as carcinogenic. (The latest such designation came after the cancer research agency of the World Health Organization convened a group of 21 scientists from eight countries in France in June 2005. Reviewing the scientific literature on the pill and cancer, the group pointed to evidence for an increase in cervical cancer, breast cancer and liver cancer in making its decision, while also stressing that convincing evidence existed for a protective effect against endometrial and ovarian cancers.) [7] Yet other authorities don't think the slightly increased relative risk for breast cancer is significant. [8]
• In my experience, the pill is also associated with mood swings, weight gain and decreased sex drive in many women.
• The birth control patch Ortho Evra and the ring (NuvaRing) are also made from synthetic hormones and have roughly the same effect as the pill, though a slightly higher risk of blood clots.
Going off the pill makes many women feel much better, although not all symptoms always subside.
Health benefits of the pill include lowered risk of ovarian cancer, endometrial cancer, acne and pelvic inflammatory disease. In general, the pill's benefits outweigh its risks for the vast majority of women because the health risks from unintended pregnancies far outweigh any risk from the pill.
Women who are on the pill should take a good multivitamin-mineral supplement containing B-complex. The majority of women who have serious health problems with the pill are smokers. Smokers should not use the pill after the age of 35.
Here's the bottom line: We have the scientific know-how to design safe and effective hormonal contraception using bioidentical hormones, which would most likely eliminate the downside of using the pill. I doubt that we will see these developed for years to come. So in the meantime, if the pill works well for you and you feel good on it, then by all means, celebrate its 50th anniversary with joy!
If, on the other hand, you are on the pill to "regulate your periods" or for some other reason, please understand that the pill does very little to "cure" any underlying hormonal imbalance. It simply puts the ovaries "on hold" artificially until such time as a woman stops taking them.
Taking the pill is an individual decision. It's neither a panacea nor a curse. In the final analysis, it has certainly done far more good than harm!
Copyright Christiane Northrup, Inc. All rights reserved. Reproduction in whole or in part without permission is prohibited.
This information is not intended to treat, diagnose, cure, or prevent any disease.
All material in this article is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise, or other health program.
References:
[1] R. Hatcher et al., Contraceptive Technology (New York: Irvington Publishers, 1991).
[2] C. Panzer et al., "Impact of Oral Contraceptives on Sex Hormone Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction," Journal of Sexual Medicine, vol. 3, no. 1 (January 2006), pp. 104-13.
[3] M. K. Horwitt et al., "Relationship Between Levels of Blood Lipids, Vitamins C, A, E, Serum Copper, and Urinary Excretion of Tryptophan Metabolites in Women Taking Oral Contraceptive Therapy," American Journal of Clinical Nutrition, vol. 28 (1975), pp. 403-12; K. Amatayakul, "Vitamin Metabolism and the Effects of Multivitamin Supplementation in Oral Contraceptive Users," Contraception, vol. 30, no. 2 (1984), pp. 179-96; and J. L. Webb, "Nutritional Effects of Oral Contraceptive Use," Journal of Reproductive Health, vol. 25, no. 4 (1980), p. 151.
[4] A. M. Kaunitz, "Oral Contraceptives," in Thomas G. Stovall and Frank W. Ling, eds., Gynecology for the Primary Care Physician (Philadelphia: Current Medicine, 1999).
[5] I. F. Godsland et al., "The Effects of Different Formulations of Oral Contraceptive Agents on Lipid and Carbohydrate Metabolism," New England Journal of Medicine, vol. 323, no. 20 (Nov. 15, 1990), pp. 1375-81.
[6] M. Bernier, Y. Mikaeloff, M. Hudson, and S. Suissa, "Combined Oral Contraceptive Use and the Risk of Systemic Lupus Erythematosus," Arthritis Care & Research, vol. 61, no. 4 (April 15, 2009), pp. 476-81.
[7] V. Cogliano et al., "Carcinogenicity of Combined Oestrogen-Progestagen Contraceptives and Menopausal Treatment," Lancet Oncology, vol. 6, no. 8 (August 2005), pp. 552-53.
[8] Collaborative Group on Hormonal Factors in Breast Cancer, "Breast Cancer and Hormonal Contraceptives: Further Results," Contraception, vol. 54, no. 3 suppl. (Sept. 1996), pp. 1S-106S.
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Just a few other points:
1) Birth control pills increase the risk of osteoporosis. One example is a good study from the journal Medicine & Science in Sports & Exercise (2001;33:873-880) which showed that young women who got regular aerobic exercise and resistance training (e.g. lifting weights) increased their bone density by one to two percent per two years, and those who didn’t exercise lost one to two percent per two years. However, women in this study who were exercising but also using oral contraceptives did not show the same benefit: their bones remained the same in spite of the exercise regimen.
2) The chemicals in oral contraceptives are the same or similar to those in hormone replacement therapy (HRT) such as PremPro, which cause an increased risk of breast cancer, heart disease, stroke and gallbladder disease.
3) The Mirena IUD, although not a "pill" uses chemical contraception, and while it works well for some women, many many women using it experience terrible side effects but never realize that is their IUD because they are never informed about the side effects. For details please read my article "Buyer Be Aware Report on Mirena" -- http://www.virginiahopkinstestkits.com/mirenareport.html --
While I understand the justifications for using birth control pills, I believe that younger women are under informed about their side effects.
Virginia Hopkins
co-author, What Your Dr May Not Tell You about Menopause
Much simpler than any of the other methods mentioned.
I wish this article emphasized the need for bio-identical hormonal birth control more & the reasons that this research has not been taken to it's conclusion. That is the part that affects us all.
So, if you can, and are done having kids, opt for something permanent.
If you want to swing, he's gotta wrap that thing!
I wonder what the long term effects will be?
It used to be that a sliver tongued guy who could talk a woman into bed would often become a father.
Now women can choose to sleep with whomever they want, but choose very selectively about who they're willing to have a baby with. So wooing a woman into bed because a useless trait.
Now women can choose someone who's stable and committed before having children. What will happen over the next 1000 years?
Will women eventually breed out the 'rogue' in men and breed in stability and commitment?
After being on the pill for about 12 years (with no issues and no side effects) I had to find another method of birth control because another medication I was on interfered with the effectiveness of the Pill. The nurse prac. I went to discussed all methods of birth control with me, including the rhythm method. Nothing was forced on me, as the writer makes it sound in this article. I decided on an IUD because of my history of irregular periods and I don't want to take a chance on getting pregnant.
Women deserve choices. And we shouldn't be made to feel like we are somehow not as 'womanly' if we choose a birth control that is not acceptable to the writer and her fan base.
I agree that when it comes to birth control, one size does not fit all. That is my whole point. But it's quite clear to me by the tone in this article that Northrup does not agree with me even though she claims to. She wants us all to throw out our birth control pills, IUD's, and any other method that she deems an 'outside source of control'. That being said, she's no better than those doctors she claims are pushing birth control on all of us unsuspecting women. Sorry, but it's my body, and I'll choose what works for me, thank you very much.
It's bad enough we have to deal with crazy fundamentalists who view birth control as immoral and that some women still have trouble obtaining it. Now we have to deal with this crap?
Why do so many people presume that birth control is only for the young, swinging singles?
lmao!
-And that says it all right there for me! That's the group of women I fall into. I use condoms every time I have sex. I won't lie. When I was in my 20s there were slip ups, but I was on birth control - and I was lucky. Now, that I am off the birth control and in control, I have a much better appreciation and understanding of my body. And, I am more cautious (as cautious as one can be) and in tune with my sexuality and sexual practises. Condoms are safer for me in the long term, as birth control - a synthetic drug touted on women for decades by BIG Pharma - is something now that I am more educated about the topic, I don't trust.
It's called the Roman Catholic Church.
It's all about choice. And as long as NFP is not shoved down people's throats like it is in Catholic and fundamentalist churches, I'm fine with any method women want to use.
NFP is NOT the same as sympto-thermal family planning! The former is guesswork, while the latter is SCIENTIFIC. Back in the day the Church told my grandmother she was not even allowed to use the rhythm method (commonly called NFP).
BTW, I use STNP and am an atheist - it has nothing to do with religion - it is the most rational, healthy method of birth-control, IMHO. Regular or irregular periods are irrelevant. Check out one of my older posts and a couple more that clarify the method if you are interested.
But as you said, I, too, am fine with whatever women choose -as long as it is an INFORMED choice that they make for themselves.
I just happen to believe that the less crap we put in our bodies, the healthier we will and the environment will be.
:-)