The pill: emblem of liberation

I have indeed witnessed very worrisome cell changes in cervical cells
of women on hormone contraceptives, especially DMPA (depot
medroxyprogesterone acetate; eg: Depot provera). With DMPA, I have often
found it difficult to distinguish the abnormal cells from endocervical
cancer cells. Knowing the woman is on the drug helps, and we as
cytologists have been taught to "down grade" DMPA cell changes (ASCP Tech
Sample CY-5, 1997) and just associate them with the effects of the drug
(1,2,3,4). DMPA and other OC's are known to deplete folic acid which
arrests cell division creating folate fragile sites on DNA strands which
in turn makes them susceptible to viral invasion (eg: HPV) as well as
other potential mutagens. These drugs can also create a cellular zinc
deficiency which further exacerbates abnormal cell division and
differentiation (5,6). Since the early 1960's, when contraceptive hormone
use began, the occurrence rate of endocervical adenocarcinoma has
increased, especially in young white women (7). Over the past fifty years,
the rate has gone from 5% to almost 25% and it continues to rise (8).
Contraceptive hormone changes in cervical cells should not be taken
lightly. They are clearly early signs of disease change, and if left
ignored (eg: no increased micronutrient support or rest from the hormones)
could manifest into cancer, heart disease, or stroke.

Weight gain in women on DMPA is another huge negative factor,
especially in women who are already overweight. A recent study found that
weight gain doubled compared to control subjects after only one year of
DMPA use in overweight young women (9). I know of young women who have
become obese using DMPA yet still ended up conceiving children. No one
really knows exactly when the drug wears off, and this is when pregnancy
occurs (similar to how pregnancy occurs in lactating women). More studies
are needed to determine just how much effect exogenous hormones are having
on the obesity epidemic we are currently experiencing, especially in
women. There are currently many websites specifically dedicated to women
who have written about their experiences with DMPA. Many of their stories
are referred to as "horror stories."

Finally, the large dosages of estrogens and/or progestins contained
in the morning after pills (eg: Plan B and Preven) are startling and
appalling. It's unbelievable that the risks of these drugs have not been
fully revealed to the public (especially to the girls and women who are
allowed to take them). Unfortunately, we will surely experience an
enormous new wave of reproductive cancers from the indiscriminate use of
these new toxic compounds. This is sad because the rates of breast cancer
from the ceasing of HRT in many women has recently dropped the breast
cancer rate significantly and for the first time in history since records
were recorded which began with the use of The Pill.

Sincerely,

Suzanne Adams, CT (ASCP)

www.i2k.com/~suzanne/cytology.htm

"Fighting the War Against Cancer and Chronic Diseases by Applying Common
Sense Practices to Everyday Living"

1. Ljuca D, Fatusic Z,Mujagic H, Ljuca F, Alispahic N. Precarcinoma
and early carcinomatous lesions in the uterine cervix and the use of oral
contraceptives. Med Arh. 2000;54(2):71-3.

2. Valente PT, Schantz HD, Trabal JF. Cytologic changes in cervical
smears associated with prolonged use of depot-medroxyprogesterone acetate.
Cancer. 1998 Dec5;84(6): 328-34.

3. Valente PT, Hanjani P. Endocervical neoplasia in long-term users
of oral contraceptives: clinical and pathologic observations. Obstet
Gynecol. 1986 May;67(5): 695-704.

4. ASCP Tech Sample CY-5, 1997.

5. http://www.umm.edu/altmed/articles/drugs-deplete-000722.htm. Drugs
that Deplete Folic Acid. Univ. of Maryland Medical Center.

6. http://www.umm.edu/altmed/articles/drugs-deplete-000728.htm. Drugs
that Deplete Zinc. Univ. of Maryland Medical Center.

7. Zheng T, Holford TR, Ma Z, Chen Y, et al. The continuing increase
in adenocarcinoma of the uterine cervix: a birth cohort phenomenon. Int J
Epidemiol. 1996 Apr;25(2): 252-8.

8. Valente PT. Squamous and Glandular Lesions of the Cervix. Can they
be reliably distinguished in cervical smears? ASCP Lab Med. 2001 Jan;
1(32): 35-37.

9. Mangan SA, Larsen PG, Hudson S. Overweight teens at increased risk
for weight gain while using depot medroxyprogesterone acetate. J Pediatr
Adolesc Gynecol. 2002 Apr;15(2):79-82

Competing interests:
None declared

I agree totally with Dr. Ellen Grant and would like to help her carry
on the word to the next generation regarding the dangers of estrogen and
estrogen-like compounds (eg: pesticides). They are not only concentrating
in women's tissues over time, but also in many other innocent creatures as
well, including men and animals. Because estrogens are not easily broken
down they are appearing in our waste water which is then discharged into
our lakes, rivers, and streams. What goes around, comes around!!

suzanne@i2k.com

Competing interests:
My loved ones that have been maimed or who have died as a result of estrogen use.

Dr. Djerassi has done well in describing the ripple effect created by
the pill in a strikingly positive light. Consideration of such ripples,
however, would be incomplete without proper illumination of equally
impressive developments in the science and use of natural family planning
(NFP) which would be a better candidate for the prize. In response to Dr.
Djerassi:

"The pill and intrauterine devices raised the expectations for
contraceptive effectiveness to an extraordinarily high level, which in
turn has had enormous favourable consequences for millions of women."

Actually, NFP in the form of the rhythm method set the original
standard against which scientific advance must compete. Even though the
pill was able to "raise the bar," the tradeoff still includes significant
health risk and the abandoning of ones concerns about taking synthetic
hormones or following ones faith. Millions of women still find this
unacceptable. Modern NFP techniques have been found to be just as
effective as any contraceptive pill that is currently available and there
are no such tradeoffs.

"The pill offers women the ability to decide on their own, in
private, whether or when to become pregnant, thus undermining the
historical dominance of men in all matters relating to sex and
reproduction. The consequences range from cultural to economic,
professional, and educational aspects, most of them positive."

So does NFP. NFP courses are almost always attended by men who
inevitably become participants in the "birth control" process and
ultimately accept responsibility for their own procreative behaviors. It
is still the woman's obligation and sole responsibility to take the pill.

"The pill and intrauterine devices introduced reversible birth
control that was independent of the sex act, completely changing the
nature of sexual intercourse, which now ranges from unworried pleasure to
undisciplined promiscuity."

The separation of procreative powers and the sex act have indeed
injected a sex for pleasure mindset resulting precisely in undisciplined
promiscuity the results of which can be observed in an exponential rise in
sexually transmitted disease, the destruction of family values, violence
against and disrespect for women by men, and governmental intervention in
population control. The explosion of sexually transmitted disease over the
last 4 decades is one of the most serious public health problems that
nations currently face.

"The pill was the first potent drug to be consumed for years by
millions of 'healthy' people, thus raising questions of defining safety
and the risk-benefit balance in the long term that were quite distinct
from those for other drugs taken over long periods (such as cholesterol
lowering drugs), where the 'benefit' was the prevention of a medical
condition. The more serious the disease, the higher the tolerance for side
effects, cancer being a classic example. In the case of the pill the
'disease' is an unwanted pregnancy, for which the level of tolerance of
side effects is very low. The discipline of epidemiology has probably been
improved in depth and sophistication more through the thousands of studies
of the pill than of virtually any other drug. No other class of drug has
been examined in such depth and for such a wide range of side effects,
from blood clots and cancer to the production of ear wax."

Blurring the lines between health and illness also has undesirable
consequences. Most notably, drug companies have exploited huge and newly
found profiteering abilities to sell drugs for health. This also
undermines truly needed preventative medicine initiatives such that it is
now easier to take pills for heartburn, high cholesterol, and etc. rather
than making appropriate healthy lifestyle changes. Important as these
treatments may be, because of this confusion, they are inappropriately
correlated with "health" care which has really only come to concern itself
with tertiary problems, the treatments of which have been enormously
profitable for well positioned stakeholders. Furthermore, the sexual
organs (particularly the female reproductive organs and pregnancy) have
since indeed attainted "disease" status. Among women, pregnancy,
menstruation, etc. are now treated according to the disease model and are
no longer considered normal physiological or normal life events. Arguably
because of the new mentality ushered in by the pill, science has
interestingly adopted the assumption that there is nothing to be learned
from normal female physiologic events such as menstruation and the natural
biophysical changes that occur during menstrual cycle. The scientific
advance towards eliminating menstruation is actually counterproductive as
it will ultimately preclude any ability to correlate normal hormonal
events with long term health or pregnancy outcomes in women. In the end,
it can be observed that a new socially engineered definition of "woman"
has been uncritically accepted by both the scientific community and sold
to women at large (as well as their partners). The consequences in both
public health and social areas have only just begun to be realized.

"No other drug has had such an enormous effect on religion. For
instance, Catholic couples, faced with their church's opposition to
contraception, often make family planning a higher priority than avoiding
'mortal' sin."

The Catholic Church's opposition to contraception has always been
inappropriately associated with "mortal" sin rather than the primary
concern which is related to "natural law." For millions of women and men
who desire to follow their faith in family planning, contraception is
unacceptable because it requires the abandonment of principle due to the
unnatural nullification of fertility in sexual encounters. NFP, on the
other hand, gives these couples a morally acceptable option that preserves
the procreative potential of the natural sex act. Sex has always been
considered sacred (and thus to be protected by the social commitments of
the marital "covenant") by the church precisely because the consequences
are new life. The church has never objected to sex occurring at any time
but in particular during infertile times (the majority of the time) or the
use of a couples knowledge of fertility patterns to make responsible
decisions. The periodic abstinence that couples may observe during fertile
times with NFP has been advocated by the Catholic Church (and other
churches) as it teaches (men in particular) respect for women and other
virtues such as self control (something with has been lost with the
introduction of the contraceptive mentality).

"The explosion of medical litigation in the most litigious of all
countries, the United States, started in the 1960s with the pill, with
consequences—beneficial and counterproductive—that greatly affected the
regulatory process for many other drugs."

The explosion of medical litigation is also one of the biggest
financial burdens in the US healthcare system, the cost of which is passed
on in the form of prohibitively high healthcare costs and insurance
premiums for patients, employers, and physicians. This problem has risen
to a crisis level and is now crippling the once world class US healthcare
system where it is causing many doctors to either retire early or
sacrifice once lucrative careers to pursue other professional options.

Competing interests:
None declared

The tenor of these responses is disturbing, and some “facts” are
dubious.

Let’s first discuss some of these facts -- for instance: “Japan's
rates of reproductive cancers are the lowest in the world.” Not according
to the World Health Organisation
(http://www.who.int/healthinfo/bod/en/index.html):

Estimated total deaths per 1,000 (year 2002)

Breast cancer Japan 10.0 USA 45.3 Australia 2.7 UK 15.0

Cervix uteri Japan 2.5 USA 4.6 Australia 0.3 UK 1.4

Corpus uteri Japan 3.0 USA 7.3 Australia 0.3 UK 1.8

Ovary Japan 4.2 USA 14.0 Australia 0.8 UK 4.5

Australia is lower than Japan for all four cancers; the U.K. is lower
for cervical and uterine cancers and similar for ovarian cancer. Why is
this? I haven’t had time to do a thorough literature search to answer this
question (if it has, indeed, been answered unequivocally, which I rather
doubt), but during my career as a medical writer-editor I have learned a
few things:

• Women’s diet in Japan has traditionally been rather different from,
say, North America or the U.K; for one thing, it has contained far more
phytoestrogens. In other words, Japanese women have been getting at least
some estrogen supplementation through their diet. How different this
effect is from the pill’s, I don’t know (I’d be interested to hear from
someone who does know); however, to imply that Japanese women receive no
estrogen supplementation seems wrong.

• Among the four countries profiled above, the United States is unique in
not offering universal health care to its citizens. The figures that I
have heard recently are that approximately 50 percent of Americans have no
health insurance, and that more than 50 percent of personal bankruptcies
in that country are due to medical expenses. Women who cannot afford
health care will not have routine Pap smears and mammograms; they will be
unlikely to see a physician because of abnormal bleeding or an unusual
lump; they will be unable to afford some or all treatments. I suspect that
the appalling lack of access to health care is at least partly responsible
for the dismal death rates in the United States.

“ ‘Estrogen is to cancer what fertilizers are to the wheat crop.’ The
latest report of a drastic drop in breast cancer in 2003 after many
menopausal women got off hormone attests to this fact.” The pill is
intended for women of reproductive age. Hormone replacement therapy during
and after menopause, although it uses the same drugs, is not for women of
the same age; you can’t equate the pill and HRT because they’re used at
different strengths at different times for women of different ages.

“Now consider the divorce rate among couples using periodic
abstinence methods (natural family planning) -- studies on these couples
show a divorce rate of <_5 id="id" like="like" to="to" see="see" the="the" references="references" for="for" this.="this." nonetheless="nonetheless" i="i" do="do" know="know" that="that" periodic="periodic" abstinence="abstinence" methods="methods" require="require" two="two" very="very" like-minded="like-minded" partners="partners" be="be" successful="successful" thus="thus" they="they" probably="probably" have="have" a="a" strong="strong" marriage="marriage" begin="begin" with.="with." its="its" my="my" understanding="understanding" it="it" is="is" usually="usually" religious="religious" couples="couples" who="who" rely="rely" on="on" this="this" method="method" throughout="throughout" because="because" of="of" their="their" feelings="feelings" such="such" are="are" unlikely="unlikely" divorce.="divorce." doubt="doubt" birth="birth" control="control" what="what" keeps="keeps" these="these" marriages="marriages" going.="going." p="p"/> As to the tenor of these arguments:

“Men have actually been liberated as they can now ejaculated [sic]
inside a women and walk away, not thinking of pregnancy. She, on the other
hand, has to fear STD's”. Men have *always* been able to ejaculate inside
a woman and walk away; men have always been able to be “no longer
responsible for their own spern [sic]”; the pill hasn’t made that any
different. If women were using diaphragms or IUDs or periodic abstinence
methods, they would still be at risk of STDs, such methods providing
limited or no protection. The women would also be at higher risk of
pregnancy. At the least the pill has allowed women far more effective
birth control than before. (By the way, I don’t believe that all men are
the callous creatures described above; I’m merely quoting someone else.)

“50% of new marriages today will end in divorce, a number which has
climbed since the Pill was introduced”. If women are able to control their
reproduction and thus be less afraid of leaving loveless, abusive, or flat-out dead relationships, I’m all for it.

“we put too high a value on our young women being sexually active,
sterile objects; not beautiful human beings worth waiting for.” I believe
that girls and women, more than boys and men, are seen as sexual objects
instead of individual humans, but I don’t see how depriving them of
effective contraception is going to make that any better. And why is being
sexually active a bad thing? Instead of teaching women to be passive,
abstinent objects “worth waiting for”, longing for a man to come along and
propose marriage and thus respectability if they get pregnant, why not let
them be proactive, thoughtful humans enjoying their sexuality responsibly?
All participants in sexual acts are responsible for their behaviour, for
discussing contraception, for not being coercive, for making sure that
they have no communicable disease. That was the case before the pill, and
it’s the case after the pill.

Women contemplating taking the pill must behave as they would if
contemplating any other medication: discuss it with a healthcare
professional, assess whether their current state of health is suitable, be
aware of the side effects. The pill is not ideal, that’s true, but it
works for a great many of us. Don’t knock it.

Competing interests:
Was happily taking the pill for years; never got pregnant.