May 12th, 2010 by Chris Hitchcock
If you’re wondering why your doctor might not take you seriously when you question taking the pill to abolish your periods, you might want to look at this piece of advice.
I had a look at the Clinical Advisor magazine information – it looks like they pay for articles, help to massage them into shape, but as far as I can tell the articles are not peer-reviewed, and the editorial staff do not have any credentials after their names, so they look like non-medical people. But it is freely available on the web, and apparently gets sent to many practicing physicians and nurses. And it’s a lot more readable than other sources of medical education.
The article is framed as a doctor-to-doctor question:
What can I do to overcome patient resistance to continuous use of oral contraceptives (OCs)? So many women say it’s not natural.—SHERRY HILL, ARNP, Bothell, Wash.
And, the answer? Explain the physiology, explain that there is no build up of old blood, that menstrual flow doesn’t have any effect on infections or toxins. And, for talking points, use the educational materials about cycle-stopping contraceptives on the Association of Reproductive Health Professionals web page (coincidentally funded with unrestricted educational funds from companies who happen to make cycle-stopping contraceptive products). And use Malcolm Gladwell’s 2000 article, John Rock’s Error, to reframe monthly menstrual flow as a historic anomaly (”you don’t need that old-fashioned thing”) and help women to see their regular menstrual flow as unnatural, so that the synthetic drugs you are suggesting will seem less unnatural by comparison.
But, ultimately, “if a patient feels that a monthly withdrawal bleed suits her best, many OCs containing 21 active pills and seven inert pills are available.”
I guess the option of using non-hormonal contraception just won’t come up.
Tags: birth control pill, CME, continuing medical education, cycle-stopping contraception, hormonal contraception, menstrual suppression, oral contraceptive pills
Posted in Birth Control, Health Care, Pharmaceutical | 2 Comments »
May 9th, 2010 by Chris Hitchcock
Today’s the day, ironically enough on Mother’s day, that marks half a century since the FDA approved the pill for contraceptive use in the USA. And, for better or for worse, it’s become part of the fabric of our culture, and allowed women to have both family and a career by providing reliable family planning. Although, as many have commented, the pill may get more credit than it deserves, it serves as a powerful symbol of women’s liberation and sexual freedom.
Recently, in the Vancouver Art Gallery, I learned that, around this time, feminist painters were bringing the body back into art, challenging the largely male trends of abstractionism. Ironically, at the same time, feminist psychologists were working to remove the body from the psychology of women, challenging the prevailing wisdom that the narrative of woman is the narrative of her womb, and that when it ceases to be productive, so does she. How does the pill, with its chemical silencing of women’s reproductive endocrinology, fit with this interplay between owning and disowning our female bodies? And how can we own our bodies without allowing them to be our only defining features?
Tags: art, birth control pill, feminism, oral contraceptive pills, psychology of women, the pill turns 50, women's liberation
Posted in Activism, Birth Control, Pharmaceutical | 1 Comment »
April 25th, 2010 by Chris Hitchcock
This week was a big one for media coverage of the 50th anniversary of the Pill. And it looks like this is also being taken as an opportunity to reflect on women’s history over the past 50 years, which will also be a good thing. Women often lose our history, and those of us who are 70 now grew up in a very different reality than those of us who are 20. I am 45, smack in the middle of that span, and it’s very interesting to me to look both forward and back. We are living through incredible changes in social history, and we need to know this to understand what is going on today and what will happen tomorrow.
The pill made the front cover of Time magazine. The author, Nancy Gibb, makes some very good points about how the existence of the pill changed young women’s ideas about the possibility of planning a career path that included being sexually active (probably in the context of marriage) but with control over the timing of pregnancy.
There’s a Time editorial here.
And there are a few interviews with Nancy Gibb, the author of the Time article, on Time’s own web page, on CNN, and NPR (Gather.com).
In the Huffington Post, Christianne Northrup discusses important social and medical context for decision-making about contraception, including the Pill.
Katrina Onstad wrote about the pill’s birthday in Chatelaine magazine.
Books and book reviews on the anniversary of the pill:
Michelle Goldberg reviews a new book about the pill in the American Prospect.
Tags: birth control pill, Media, oral contraceptive pills, social history, the pill turns 50, women's liberation
Posted in Birth Control, Media, Newspapers, Pharmaceutical, books, magazines | Comments Off
April 23rd, 2010 by Chris Hitchcock
Recently the New York Times published a long article entitled the Estrogen Dilemma. It’s an article rich with many issues, and previous blogs have critiqued its uncritical acceptance of the timing hypothesis, and its failure to distinguish between the transient symptoms of perimenopause, early menopause, and the rest of your long, healthy, post-menopausal life.
But it is quite remarkable to me that, when speculating about potential hormonal treatment for poor memory and issues of staying on task, the only steroid hormone that seemed to be on anyone’s radar was estrogen. The writer had a lot of space (7600 words) and gave the scientist a lot of freedom to speculate, so I’m guessing that the absence of progesterone in the article is a true representation of her conceptual blind-spot. Progesterone was mentioned a few times, in the context of protection from uterine cancer, and in the context of using MPA (a synthetic relative) as a possible scapegoat in interpreting the WHI randomized hormone therapy trial data. But never did I see any suggestion that progesterone might be anything other than a necessary evil.
In fact, there are some intriguing new research areas that look at progesterone as therapy in neurological domains. Continue reading...
Tags: big pharma, estrogen, hormones, neurology, progesterone
Posted in Menopause, Menstruation, New Research, Newspapers | Comments Off
April 23rd, 2010 by Chris Hitchcock
Tags: blood, breast milk, C'elle, cancer, HAMLET, hormone therapy, life-giving fluids, Menstruation, ovulation, science, Shakespeare, stem cells, vaginal bleeding
Posted in Menstruation, New Research, anatomy | 3 Comments »
April 20th, 2010 by Chris Hitchcock
It’s starting. With the approaching 50th anniversary of the birth control pill, there will be a flood of anniversary celebrations and reviews of birth control methods. Which is good. We should have those discussions more often. Just say “no” (on the part of parents who don’t want to hear about it) is a big contributor to unwanted teen pregnancy.
Today’s Wall Street Journal is running an article called The Birth-Control Riddle. The riddle is apparently the high rate of unwanted pregnancy, despite the availability of a range of effective birth control methods. And, as befits the Wall Street Journal, each birth control method is accompanied by a price tag, so you can make an informed consumer decision.
But what I noticed was that there is no real awareness of what we at SMCR feel is an important consideration: Does your birth control method stop your cycle?
Some methods do – they deliver progestins and/or estradiol in high enough doses to act on the parts of the brain that normally make the hormones that talk to the ovaries that stimulate growth of a follicle, then trigger its release. This is a complex, whole body system, that normally we only notice because of uterine effects (that would be menstrual bleeding or pregnancy). And as a culture we have fairly casually accepted the idea that it is optional, and perhaps even optimally replaced by a pill made by a drug company. Continue reading...
Tags: birth control pill, contraception, IUD, Mirena, oral contraceptive pills
Posted in Birth Control, Health Care, Menstruation, Pharmaceutical, Reproduction, Sex, ovulation | 4 Comments »
February 21st, 2010 by Chris Hitchcock
The American Psychiatric Association has pushed back their timeline for the 5th version of the Diagnostic and Statistics Manual. The new psychiatric bible was originally scheduled to come out in 2011, but has now been delayed to 2013 .
Initial drafts have been posted to the web page, but the controversial and provisional (that is, not yet officially accepted) diagnosis of premenstrual dysphoric disorder (PMDD) does not yet appear ready for comment. Which is a shame, because traditionally SMCR and its members have had a lot to say about PMDD, and we’re looking forward to the opportunity to consider and critique its new incarnation. Here’s a recent post as an example.
PMDD was first introduced in the DSM-III-R as Late Luteal Phase Dysphoric Disorder. The “late luteal” was meant to include cycling women who did not bleed, for example, those with a hysterectomy but preserved ovaries, but was criticized because “luteal phase” implies ovulation, and assessing ovulation was not part of the diagnosis.
Paula Caplan (e.g. this article) and other members of the SMCR were vocal in their challenge to the psychiatric label. Paula Caplan wrote a book about her experiences with the DSM process (They Say You’re Crazy), and the SMCR produced the following position statement: Continue reading...
Tags: American Psychiatric Association, APA Diagnostic and Statistics Manual, DSM, DSM-V
Posted in Activism, Health Care, Menstruation, PMDD, PMS, Pharmaceutical, ovulation | Comments Off
February 20th, 2010 by Chris Hitchcock
In honour of the fabulous Laurie Anderson (whose Delusion performance I will be attending this evening), I wanted to share a link to her song Beautiful Red Dress from the Strange Angels album. It’s full of powerful imagery, and, as always for her, that bit of strange.
Cause the moon is full and look out baby -
I’m at high tide.
I’ve got a beautiful red dress
And you’d look really good
standing beside it..
I’ve got some beautiful new red shoes
and they look so fine
I’ve got a hundred and five fever
and it’s high tide.
And here’s a nice piece of rich poetry about menstrual cyclicity of mood:
Well they say women shouldn’t be the president Cause we go crazy from time to time
Well push my button, baby
Here I come
Yeah, look out, baby
I’m at high tide
I’ve got a beatiful red dress and you’d look really good standing beside it..
I always love the way she plays with words, and she captures both the power and the double-edge of being a menstruating woman, being a woman at all. What can I say, I’m a fan, and looking forward to tonight. I hope you enjoy it. Continue reading...
Posted in Media, Menstruation, Music, PMS | 1 Comment »
January 1st, 2010 by Chris Hitchcock
The bioidentical hormone therapy industry has been getting a bad rap lately in the US, and this press release is an example of why. Among other things, the writer confuses estrogen and progesterone, in one paragraph saying their product is a “safe and scientifically-proven, all-natural estrogen delivery cream[]“, and in the next describing it as a “natural progesterone cream” (emphasis is mine). Moreover, the press release springboards from another estrogen-positive press release that claims that estrogen may be the cure for female depression, citing an ob/gyn author of a book, and promoting a soon-to-be-launched web page.
So, in one breath the product is an estrogen delivery cream that will help with low estrogen, but in the next breath (on the linked product page) it is argued that it will help with estrogen that is too high (which is more accurate). The product website emphasizes that it is “without dangerous pharmaceuticals”:
This remarkable product contains NO risky synthetic estrogens or progestins. [Product] Cream is similar to the progesterone your body naturally produces, so there are no worries about dangerous interactions or nasty side effects. Continue reading...
Tags: bioidentical hormone therapy, critical thinking, estradiol, hormone therapy, Menopause, postmenopause, progesterone
Posted in Health Care, Menopause, Pharmaceutical | 3 Comments »
Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.
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