birth control Archives - Page 9 of 10

Birth Control vs Hysterectomy in Catholic Hospitals

by WS

Published on September 4, 2013

8697 views

I was raised Catholic but did not agree with some of Church doctrine and left the Church as a young adult. In my wildest dreams, I never imagined that I would have a hysterectomy and be castrated in a Catholic hospital (or any hospital for that matter) for a benign ovarian cyst. You can read about my Unnecessary Hysterectomy here. I suspect many other women have had healthy organs removed at this greater metropolitan Catholic hospital or some other Catholic hospital. With hysterectomy the second most common surgical procedure and the prevalence of Catholic hospitals growing, millions of women likely have had unnecessary hysterectomies at Catholic hospitals. This made me wonder, why would the Catholic Church condone (and profit from) unnecessary hysterectomies but prohibit contraception. It seems a bit hypocritical at least, unethical at worst.

A Spider Web of Contradictions in Catholic Hospitals

Catholic doctrine prohibits contraceptives. Yet, Catholic hospitals perform hysterectomies and ovary removals (castrations) for benign conditions that can typically be treated with less drastic measures such as contraceptives. Hysterectomy is permanent birth control. So is removal of ovaries. How is hysterectomy justified but not contraceptives?

In an article entitled Do Religious Restrictions Force Doctors to Commit Malpractice, the hazards of treatment at religious hospitals are discussed. In the case of a potentially fatal ectopic pregnancy, removal of the fallopian tube which negatively affects fertility complies with Catholic doctrine while an injection of methotrexate that preserves the tube and fertility does not.

According to Catholic moralists, an injection that destroys an ectopic embryo is a direct abortion, while removing the part of a woman’s reproductive system containing the embryo is not.

But the end result is the same – a pregnancy is terminated. So why not at least preserve the woman’s fertility and health-promoting hormone production by administering the drug versus removing her fallopian tube?!

Another story in the cited article involved a woman with Lupus who was pregnant with a nonviable anencephalic fetus. Although continuing the pregnancy risked the woman’s health and her very life, pregnancy termination was denied.

The above situations would be considered medical malpractice since they caused harm to the patients. And what makes even less sense is that neither of these were viable pregnancies. Catholic Church dogma caused (intentional) harm to these women.

Another treatment done in Catholic hospitals that has me scratching my head is endometrial ablation. Although it reduces fertility, pregnancy can still occur but can be dangerous to mother and unborn child. So some form of birth control is recommended after ablation if tubal ligation was not also performed. Yet according to Is the Novasure System Ethical?, Novasure ablation has been given a passing grade by the Catholic Church. With the Church’s mandate against contraceptives, I wonder how many women are prescribed contraceptives to treat their heavy bleeding BEFORE this procedure is offered. However, in defense of the article, it does state that drug therapy is typically the first-line treatment after doing a full work-up to determine the cause of the bleeding. And if that fails then D&C should be the next step which should include polyp removal if polyps are found. However, it does not mention removal of fibroids despite being a common cause of abnormal bleeding. Although the article recommends starting with conservative treatments, the high rate of unwarranted hysterectomies and ablations indicate poor compliance with these standards.

According to a study published in 2008, the long-term problems caused by ablation too often lead to hysterectomy, the rate being highest (40%) for women having the procedure before age 41. This is further discussed in Endometrial Ablation – Hysterectomy Alternative or Trap?. However, again, in defense of the above cited Novasure article, it was published in 2005, three years prior to this study on the long-term effects of ablation. And, in addition to surgical risks, the article does mention the long-term risks of accumulation of blood in the uterus and the risk of impeding diagnosis of endometrial hyperplasia or cancer. Despite this 2008 study showing the long-term harm of ablation, the use of this procedure does not appear to be declining.

According to Catholic Doors,

To obtain a hysterectomy is a mortal sin.
The ruling by the Congregation for the Doctrine of the Faith stipulates that the only time a woman is morally permitted to have a hysterectomy is when the uterus is so damaged it presents an immediate threat to her health or life. [National Catholic Reported; August 12, 1994]
In general, an hysterectomy is morally justified if the removal of the uterus is necessary for grave medical reasons. It is not justified when the purpose is direct sterilization.
Therapeutic means which induce infertility are allowed (e.g., hysterectomy), if they are not specifically intended to cause infertility (e.g., the uterus is cancerous, so the preservation of life is intended). [Humanae Vitae]

Unnecessary Hysterectomy, Ethical Principles and the Hippocratic Oath

Birth control issues aside, how do all these overused gynecological procedures comply with the three ethical principles of the Catholic Church – respect for persons, beneficence, and nonmaleficence? For that matter, how do they comply with the Hippocratic Oath to “first, do no harm?” Since they cause harm, they violate the three ethical principles of the Catholic Church as well as the Hippocratic Oath. One must question if women are getting INFORMED CONSENT in any facility, religious or secular, but that is a topic for another day.

Ascension Health defines beneficence as follows:

As a middle principle, the principle of beneficence (and nonmaleficence) is the basis for certain specific moral norms (which vary depending on how one defines “goodness”). Some of the specific norms that arise from the principle of beneficence in the Catholic tradition are: 1) never deliberately kill innocent human life (which, in the medical context, must be distinguished from foregoing disproportionate means); 2) never deliberately (directly intend) harm; 3) seek the patient’s good; 4) act out of charity and justice; 5) respect the patient’s religious beliefs and value system in accord with the principle of religious freedom; 6) always seek the higher good; that is, never neglect one good except to pursue a proportionately greater or more important good; 7) never knowingly commit or approve an objectively evil action; 8) do not treat others paternalistically but help them to pursue their goals; 9) use wisdom and prudence in all things; that is, appreciate the complexity of life and make sound judgments for the good of oneself, others, and the common good.

Why is Hysterectomy So Pervasive at Catholic Hospitals?

For Catholic hospitals with accredited Graduate Medical Education (GME) programs, resident minimum surgical requirements may very well increase the rate of unwarranted hysterectomies. But that is certainly a poor excuse for removing an organ. Even so, if they can get around the GME abortion requirements for religious reasons (Catholic hospitals will not perform abortions) they should be able to do the same for hysterectomies, 98% of which do not meet the “grave medical reasons” test.

Hysterectomies and ablations (that too often lead to hysterectomy) are big business. Hysterectomies are estimated at generating $5-16 billion annually, and so revenues may be another reason Catholic hospitals prefer gynecological procedures over medical (pharmaceutical) intervention (birth control or other). Refusing to prescribe contraceptives may increase their ablation and hysterectomy business and therefore their bottom line. So the 76% of hysterectomies that don’t meet ACOG criteria may be even higher in Catholic hospitals. And the ongoing negative health effects of these procedures further contribute to the bottom line of these “health care” conglomerates.

Could profits trump Catholic doctrine on contraceptives and Catholic ethical principles when it comes to performing destructive gynecological procedures in Catholic hospitals?

My experience certainly proves this as all my sex organs were removed for a benign ovarian cyst, certainly not a “grave medical reason.” I can say the same for many other women with whom I’ve connected since my unwarranted hysterectomy and castration. And the overuse of ablation appears to be just as rampant. This procedure is being done on women in their 20’s and 30’s, many of whom are now considering hysterectomy or have had one to get relief from the post-ablation pelvic pain.

Just as a man’s sex organs have lifelong (non-reproductive) functions, so do a woman’s. Any procedure that disrupts their normal functioning can cause permanent adverse effects. At least medications can be stopped if the side effects outweigh the benefits.

For more information on the necessity of the uterus beyond the childbearing years, watch this video.

Participate in Research

Hormones Matter^TM is conducting research on the reasons for and outcomes of hysterectomy. If you have had a hysterectomy, please take this important, anonymous survey. The Hysterectomy Survey.

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

To sign up for our newsletter and receive weekly updates on the latest research news, click here.

The History and Future of Abortion Laws in America

by Lisbeth Prifogle, MFA

Published on September 3, 2013

3781 views

The article you are about to read is neither an look at the morality of abortion nor a defense for women’s rights. It is a look at the history, future and constitutionality of abortion laws. I am neither pro-choice nor pro-life. I’m not republican or democrat. I am not a feminist. I don’t believe we should categorize and label ourselves over generalities because each choice we make has the potential to redefine who we are and who we think we are. That being said, it was extremely difficult to drudge through websites to find facts on this subject. The argument for/against abortion has been so politicized that every site has a slant. I did my best to leave politics behind and just look at the facts on this subject.

In the Beginning

When America was founded, abortions were legal. There were those for it and against it then as there are now, but it did not affect the laws. There were homes for unwed mothers and campaigns to “adopt not abort,” but the state did not have any laws on the books until the mid-to-late 1800’s.

The American Medical Association

The American Medical Association (AMA) was the catalyst for the first abortion laws, but for reasons you wouldn’t likely expect. Through criminalizing abortion, the AMA could push midwives, apothecaries, and homeopaths out of business by eliminating their principle procedure – abortions. Think about this, the AMA was against abortion for reasons related to business, position and profit and used the morality argument as the wedge.The AMA set the stage for what we see now. It introduced the pro-life side so it could corner the market on the abortion business. The AMA argued that abortion was immoral and dangerous and by 1910, every state had laws forbidding it unless it was to save a woman’s life, in which case a physician would perform it. No more midwives, apothecaries or homeopaths.

Did these laws protect women? No, back-alley abortions increased and more women died from complications. These back-alley abortions weren’t necessarily only unwed or unfit mothers either, women who had medical complications with the pregnancy but couldn’t afford to go to a physician could no longer seek out a midwife or other practitioner to conduct the procedure.

Margaret Sanger

In the 1900’s Margaret Sanger started educational campaigns for contraceptives because she opposed abortion. (For more information about Margaret Sanger, her involvement in founding Planned Parenthood, and her involvement in the Eugenics Movement in America read The History of Birth Control and Eugenics). As a proponent of the eugenics movement she had an agenda to keep, “More children from the fit, less from the unfit,” (Birth Control Review, May 1919, p. 12), but she did not pursue this agenda via abortions. As a nurse she cared for many women who died from complications of botched abortions and was very opposed to the practice because of the danger it imposed on women. Interestingly enough, Margaret Sanger founded the American Birth Control League, what we now know as Planned Parenthood. Today, Planned Parenthood performs legal abortions with government funds. Although it is ironic, I suspect that Sanger would likely approve of the procedure today because it is now a much safer procedure for women than it was during her time.

Roe v. Wade

Jumping ahead a bit to 1973, we come to the landmark case of Roe v. Wade. Texas, along with most other states had strict abortion laws that only allowed it if the women’s health was in danger. In this case, a 21-year-old woman brought a class action suit opposing the constitutionality of the law against abortion. She won. The Supreme Court ruled that the laws restricting women from having an abortion violated the Due Process Clause of the Fourteenth Amendment:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

Today, this case is still the basis for the approval or rejection, and appeal of state and federal laws.

Today

The controversy remains heated. In 2012, Arizona passed a law that made it illegal for women to have abortions after 20 weeks of pregnancy, but in May 2013, aU.S. Court of Appeals in San Francisco ruled that the measure violates controlling U.S. Supreme Court precedent under the court’s 1973 decision in Roe v. Wade. It was a unanimous ruling. However, prior to the Court of Appeals decision, federal judge James Teilborg ruled the law constitutional because it did not prohibit women from ending their pregnancy, just forced them to do it earlier in the pregnancy.

More recently, on July 18, 2013 Texas Govenor, Rick Perry signed a law making it illegal for a woman to have an abortion after 20 weeks of pregnancy. Texas joins 12 other states with similar laws.

While I’m a firm believer of State rights under the Tenth Amendment (which is why each state has different abortion laws). Legislation should not be based on what is considered right or wrong according to a politician’s beliefs; laws should be based on what is safe for the citizens the law is supposed to protect. Is an abortion after 20 weeks unsafe? That is a discussion we have not had. It’s certainly not common; according to the Guttmacher Institute, an abortion rights organization, it is estimated that only that 1.5 percent of abortions takes place after 21 weeks of pregnancy.

The Slippery Slope

In recent years, several states have passed “wrongful birth” laws. These laws prohibit medical malpractice lawsuits against doctors who withhold information from a woman that could cause her to have an abortion. Who are these laws protecting? The patient? The politicians’ re-election campaigns? The doctors? Take a minute to set your personal beliefs aside and think about this – there are laws that allow doctors to withhold medical information that could jeopardize the life of both the mother and fetus. How is that safe? How is that even remotely constitutional? How is it more morally acceptable to potentially allow both mother and child die in order to prevent an abortion? Yet, we the people have accepted it.

The Future

While most arguments about abortion never make it past debating morality and women’s rights, these laws and debates should dive into much deeper issues – state rights, separation of church and state, and the role of the government in our everyday lives. I can’t say whether or not abortion will be legal or illegal in five years or fifty, but one thing I know for sure is the absurdity of the bills introduced, laws passed, and what politicians say will continue to get out of control. Unless, we as citizen’s speak up.

I’m sure we all remember Representative Todd Akin’s statement in August 2012 on the subject of his opposition to abortion even in the case of rape, “If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.”

More recently, in January 2013, a bill was introduced in New Mexico that would prevent abortion in the case of rape or incest because it would be considered “tampering with evidence in cases of criminal sexual penetration or incest.” This bill would make an abortion in the case of rape and incest a third degree felony potentially punishable by up to three years in prison!

I wish I was making this up, but as the saying goes, the truth is stranger than fiction. In my opinion, it’s all razzle dazzle to distract the public from the fact that we don’t need, nor should we have laws for or against abortion, but instead have regulations that monitor the safety of the procedure as it changes with technology. Maybe in the future voters will see the deeper issues in this debate and undo what the AMA set in motion in the pursuit of profit, power and prestige.

Not Endometriosis. Now What?

by R S

Published on June 25, 2013

27750 views

I was functioning under the assumption that I had endometriosis. It seemed the most likely disease based in the information given me by my doctors. I underwent a diagnostic laparoscopy and waited for my surgeon to follow up with me.

It’s Not Endometriosis

As it turns out, I don’t have endometriosis and my internal structures appear normal. I’ve been referred to a pain management specialist. It has been suggested that I might see a neurologist as well. “If we can’t find the cause, we can at least treat the symptoms. You may have a rare form of cystitis, or you may not. Please try to focus on the good news: you don’t have cysts or tumors or scar tissue,” said my surgeon. I admit I was very disappointed in a strange way. It’s the very human need for an explanation. Without a known cause, how can we stop this from returning again?

Four days after surgery, I got food poisoning. I recovered after five days.

However, now I am terribly dizzy and have severe fatigue. Is it related to the endometriosis-like abdominal pain or something else? I can barely stay awake. In fact, I sleep most of the day and night. It’s not sleepiness. I simply cannot stay conscious. I’m always hungry and eating, but I’m losing weight slowly. There is ringing in my ears on and off. I find myself confused by simple tasks. I tried to fry an egg on a good day and found I couldn’t lift the pan. I’ve fainted twice last week: once after a blood draw, and once just in my home after a stressful conversation.

My general practitioner has run blood tests for anemia, vitamin deficiency, diabetes, and thyroid disorders, as well as a comprehensive blood count. He also told me that most of the time, when trying to diagnose fatigue and dizziness, these blood tests come back normal. I should be prepared to search for other answers. Diabetes and thyroid disorders run in my family, and I’m really hoping it’s easily found out so I can find treatment soon. My ears were checked for infection, and they appear fine. He also suggested that it could be severe depression, but I’m not so sure. I’ve had depressive episodes before, and while I was sluggish and slow to make decisions, I wasn’t this dizzy or weak.

Symptoms that Led Us to Suspect Endometriosis

As for the pelvic pain, it started in late November, very sharp and stabbing on the right-hand side over my ovary over the course of two days, growing rapidly more painful. The ER docs said it was a ruptured ovarian cyst, and noted that when pressed, my left ovary was very tender and painful as well.

That pain was supposed to heal in three to five days and just didn’t, growing less stabbing. It was a constant ache, day and night, for four months over my right lower quadrant with intermittent sharp cramping. When pressed, my left lower quadrant was just as painful, but didn’t throb or cramp on its own.

A course of progesterone halved the pain. Birth control dampened it a bit more. Hot baths and heating pads also helped somewhat. Exercise made it much worse, as did standing and walking for even short periods or leaning over. Pelvic exams and ultrasounds also hurt very much. Going to the restroom hurt terribly.

What really helped was removing the benign tumor in my colon. Some of the pain had been very bad intestinal cramping throughout my abdomen. I have most of my mobility back now. Occasionally, it will feel like there are hot, throbbing points in my pelvis for about three to six hours at a time, usually on the right side. Advil, a heating pad or ice pack, and lying very, very still help.

Also, since November, my periods have been dreadful. Terrible cramps like I’ve never had, and the week before and after my period, I’m very tender throughout my pelvis and it feels like I’ve thrown my lower back out. They never used to be this way.

After the laparoscopy, where everything was found normal, I had sharp, hot throbbing for several days over my right ovary again. The surgeon said she has no explanation except for perhaps a very uncommon form of interstitial cystitis, but I don’t have half of those symptoms. Sitting in a moving car and long walks cause a sharp ache on the right side of my pelvis, but it isn’t constant like it was for three months beforehand. The pelvic pain comes and goes, and it’s about one-third of its former intensity. I don’t know what would cause it to come back full force and constantly, but I hope it never does.

After seven months of poor health, I’m baffled by all my tests returning normal. If it’s not endometriosis, then what is it? If these tests come back normal, I’m not sure what other steps to take.

Take these pills!

by Lisa Graham

Published on June 14, 2013

3831 views

Good morning young lady
Please lie on this slab
It really won’t hurt, not a bit –
Please relax.

I see nothing wrong,
no reason for pain –
However some women
do tend to complain.

Here, take this packet,
it’s commonly used
by women with many more
problems than you.

Some pain is just normal,
no reason to fuss –
just take these small pills
and return in three months.

If this doesn’t work, we’ve got
more you can try.
If you’re sad that is normal –
it’s normal to cry.

It’s normal to suffer-
you must be very weak.
Other women, just like you,
tough it out, so to speak.

These pills are quite safe.
They prevent any pain.
This means what you feel
must be caused by your brain.

Lisa lives in Homer Alaska with her amazing husband, and is an advocate for endometriosis awareness, education, and higher standards for women’s health worldwide. She works in Quality Assurance, and she dreams of saving the world with poetry and organic vegetables. She is currently pursuing a Master’s Degree in Project Management.

Look Beyond Access – Demand Safe Birth Control

by Chandler Marrs, PhD

Published on February 21, 2013

6977 views

Fair warning, this may get ugly. I’m mad. Bayer just announced the next in a long line of dangerous hormonal birth control options the Skyla IUD. Though not much different from the currently embattled and lawsuit ridden Mirena (which tends to dislodge and cause hemorrhage among other things) and likely not much safer than their oral contraceptives – the Yasmin line ($700 million in lawsuit settlements and counting) – women’s health and feminist groups are jumping on the support bandwagon. Now younger women can get a (dangerous) IUD too (Skyla happens to be just a hair smaller than Mirena), yippee.

Wake up, ladies. Medical devices and pharmaceuticals are not shiny new iPads. We cannot blindly support and recommend each and every new product in this market.

The fight to give women access to birth control as a point of equality is dead on and much needed, but ignoring the safety issues and not demanding safer birth control options is just downright negligent. Advertising these birth control options without understanding the serious dangers makes us pawns of pharmaceutical industry and complicit in the deaths and injuries of the women who use these devices and medications.

Women need birth control options. I support that – wholeheartedly. I am a child of the 80s-90s when access to oral contraceptives was unquestioned. Access to birth control allowed me to compete against guys in my chosen sport, allowed me to date, to pursue academic and career goals without worrying about pregnancy. Easy access to oral contraceptives also, unbeknownst to me, elevated my blood pressure to dangerously high levels, caused progressively worse vertigo and syncope to the point of multiple hospitalizations, tests and desperation. I stopped taking oral contraceptives and all of the symptoms resolved. It wasn’t until years later that I understood the connection.

Like so many others, my physicians and I were blind to the legitimate dangers of hormonal birth control. Sure we’ve all read the package inserts (which are really the tip of the adverse event iceberg), but in a sort of cognitive dissonance we dismiss the side-effects as happening to someone else or as something to be tolerated in exchange for our freedom. Physicians often downplay the dangers hormonal birth control, even today, as more research comes to light.

Imagine, pregnancy versus possible death from cardiac arrest, stroke or a myriad of other adverse events; that is the choice we make daily when using hormonal birth control. We shouldn’t have to make that choice. As educated women and modern feminists we must be able to distinguish between fighting for the absolute right to have access to birth control from a stance that says all birth control options are good and safe. The later is most certainly not the case.

Not all contraceptives are created equal. Some really and truly, should not be on the market. Even among the safer birth control options, there are dangers. We should be fighting for more research, for better and safer birth control options and not promoting each new pill or device that comes on the market. Just because it’s new and the makers say it is safe does not make it so. The pharmaceutical industry has a long history of publishing only positive results for their products (here, here, here) and paying physicians to promote their products. If ever there were a buyer beware, it would be here – with birth control.

Finally, we should be boycotting companies like Bayer who continue to put women’s lives at risk. We boycotted Rush Limbaugh and the Koch brothers for their anti-women statements, why are we not as aggressive when it comes to companies that seriously injure women? At the very least, we should not be promoting their latest, greatest assault on women’s health. Bayer is the maker of the Yasmin line of birth control, arguably the most dangerous line of oral contraceptives on the market. Bayer is also the maker of Mirena, the hormonal IUD with on-going class action lawsuits due to serious adverse events. Skyla is almost equivalent to Mirena and is simply repackaging and re-branding of that old, soon to be off-patent, dangerous IUD. It is neither new nor innovative and it remains to be seen whether it is any safer. What are we doing ladies?

Post Script: Hormones Matter^TM is taking the safety of birth control into its own hands. We find it unacceptable that the adverse events of many birth control options are poorly understood, that medication interactions are not investigated and that oral contraceptives (like many other medications in women’s health) are regularly prescribed for uses for which there are no data to support their efficacy. We are conducting our first of many studies on oral contraceptives and women’s health issues. If you have ever used oral contraceptives, whether you had any side-effects or not, please take the Oral Contraceptives Survey. Another woman’s life may depend upon it.

About us: We are an unfunded company, committed to improving women’s health through research. We believe so strongly in the need for better research that rather than wait for funding, we’re doing the research anyway. We are crowdsourcing this research and would be much appreciative if you would also share the link throughout your social media networks. To take another health survey, click: Take a Health Survey.

To suggest a survey, help create a survey, write a guest post or otherwise get involved: info@hormonesmatter.com

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.

Over the Counter Birth Control Pills

by Chandler Marrs, PhD

Published on December 10, 2012

4305 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.

Oral Contraceptives Linked to Heart Attack & Stroke

by Elena Perez

Published on September 15, 2012

3402 views

In June, researchers at the University of Copenhagen published the largest cohort study of hormonal contraceptives and their association with heart attacks and strokes. The study followed more than 1.6 million Danish women, ages 15 to 49, for a 15-year period between 1995 and 2009, allowing researchers to observe more than 14 million person-years, or the total number of years that oral contraceptives were used during this study.

The findings are worth mentioning.

Risk of Heart Attack and Thrombotic Stroke

Though researchers stated the risk of myocardial infarction (heart attack) and thrombotic stroke (stroke from blood clotting) was quite low, the study still showed a link between the two. Overall, 21 strokes and 10 heart attacks occurred for every 100,000 person-years of study.

The Type of Hormone Can Increase Risk

Women who took oral contraceptives with 20 micrograms of ethinyl estradiol increased their risk of heart attack by a factor of 1.7. Using 30 to 40 micrograms of ethinyl estradiol increased strokes by a factor of 1.3 and heart attacks by a factor of 2.3. The type of progestin, however, only changed the risk slightly, according to researchers.

Since the type of hormones used in oral contraceptives can increase the risk of heart attack or thrombotic stroke, women should ask their doctors about the dosage and types of hormones in their oral contraceptives and why the brand was chosen for them. It is important for women to question the prescriptions they are given, because FDA regulations may not be sufficient.

Yasmin is an example of a hormonal contraceptive that uses ethinyl estradiol. AdverseEvents.com has 16,546 adverse reports listed for Yasmin. Of these, 9,847 of the reports suspect that Yasmin is the primary reason for various illnesses, such as pulmonary embolism (blockage of the main artery of the lung), and deep vein thrombosis (blood clot in a deep vein).

In May of 2011, the FDA reported that studies show women using oral contraceptives with drospirenone are two to three times more likely to suffer from venous thromboembolism events (VTE), or blood clotting in the veins. The FDA stated it would evaluate results, but oral contraceptives that contain drospirenone, such as Yasmin, are still on the market.

Understanding the quantity and the type of hormones that are linked to adverse effects can help women determine which oral contraceptives are best for them. Bear in mind that a woman’s choice in oral contraceptives may change over time, depending on factors such as age.

Age Increases Risk of Heart Attack and Thrombotic Stroke

Women using oral contraceptives in the oldest age group, age 45 to 49, were found to have a higher risk of heart attack and thrombotic stroke than women in the youngest age group, between 15 and 19 years of age. The risk of thrombotic stroke increased by a factor of 20, while the risk of heart attack increased by a factor of 100 for women between the ages of 45 and 49.

The researchers felt this information was particularly important, since the risk of blood clotting and heart attack outweigh the risks of pregnancy. Risk of arterial thrombosis, or clotting of the arteries, increases after the age of 30, so women using oral contraceptives should be aware of the increased incidence of heart attack and stroke as they age, and may want to consider alternative forms of birth control.

Correlation Between Level of Education and Risk

The study also found that women with the highest level of education were less likely to have thrombotic strokes and heart attacks. In fact, educated women had half as many thrombotic strokes and only a third of the heart attacks as women with the lowest level of education.

There are a number of reasons that may account for why women with the highest level of education have a lower level of heart attacks and thrombotic stroke.

A study published in the International Journal of Epidemiology found that one’s socioeconomic status, which takes into consideration education and occupation, does affect diet and nutrition. If women with the highest level of education are more likely to eat healthy meals and minimize consumption of fried food, their diet could be the reason for the reduced the risk of heart attack and stroke.

It is also likely that women with higher levels of education exercise more, thereby improving their heart conditions. Women with higher educations may be more aware that exercise can help maintain good health. It is also possible that women with lower levels of education have longer work hours and less time to exercise, which could negatively impact coronary health.

In addition to diet and exercise, women with higher levels of education may be more likely to stay abreast of news and current events that highlight which habits are considered healthy (like meditation) or harmful (like smoking), which pharmaceutical drugs are being evaluated (like Yasmin), and who can be trusted to provide unbiased information (question everything).

Share the Knowledge

One of the main researchers, Dr. Lidegaard, received grant support from Bayer Pharma, while lecture fees and travel reimbursements were paid by Bayer Denmark. He also provided testimony in a US legal case involving oral contraceptives and venous thromboembolism. Bayer happens to be the pharmaceutical company that makes Yasmin, the oral contraception reported on AdverseEvents.com.

The other main researcher, Dr. Løkkegaard, received travel reimbursement from Pfizer, a pharmaceutical company that manufactures Lybrel, an oral contraceptive with 20 micrograms of ethinyl estradiol. The Material Safety Data Sheet for Lybrel acknowledges its association with myocardial infarction, strokes, and blood clotting of the veins.

Women who recognize that a conflict of interest may produce biased results may wonder how low the risk of myocardial infarction and thrombotic stroke really is. It’s important to ask questions. It’s important to share knowledge. One way to educate women is by spreading the word.

Natural Fertility Awareness – Tools for Tracking

by Elena Perez

Published on September 5, 2012

3946 views

I was hanging out with some girlfriends the other night, and we were discussing our methods of contraception. I take the crazy pill (i.e. birth control pill), Jen has Implanon in her arm, Carson uses condoms, and Natalie relies on the rhythm method. Seriously.

She was previously taking the pill, but switched methods because the change of hormones was affecting her libido. And if you’re not interested in getting it on, there’s no reason to be on the crazy pill anyhow.

Natalie refers to this method of contraception as Natural Fertility Awareness, but informed me that it is also known, as Natural Family Planning. If you use several Natural Fertility Awareness methods to predict ovulation, it’s referred to as the Symptothermal Method.

Natural Fertility Awareness – Risks and Routines

I’m interested in Natural Fertility Awareness because I want to veer away from the pill – I’d rather not bombard my body with additional hormones on a daily basis. Natural Fertility Awareness, however, sounds like the method they taught at my Catholic high school: Track your basal body temperature, monitor the viscosity of your cervical mucus, and pray.

I never felt comfortable with Natural Family Planning because the risk of becoming pregnant is high: The Mayo Clinic estimates that 13 to 25 out of every 100 women become pregnant using the rhythm method. If the Virgin Mary could become pregnant without intercourse, I have no doubt that Natural Family Planning is a risky undertaking.

Natalie informed me that tracking ovulation also takes time and effort. Not only must you monitor your temperature and cervical mucus daily, but you need to track your menstrual cycle and determine which days you are likely to ovulate as well. This data is then used to calculate the best time to have sex, depending on whether or not you want to start a family.

Hormones Matter

Where health, hormones, and a whole bunch of other stuff, make sense.

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