Blog of the Society for Menstrual Cycle Research

The pill, reduced period pain and the ongoing delusion

January 20th, 2012 by Laura Wershler

Is there a woman over the age of 18 anywhere who doesn’t know that taking the birth control pill can make her periods lighter and less painful? Most women know this, but not many know why. The news stories swirling around a new study about the pill and period pain will not enlighten them.

Photo credit: Ceridwen, Creative Commons 2.0

A 30-year longitudinal Swedish study has finally proved the worth of what is accepted practice in North America and Europe: the prescribing of combined oral contraceptives (COCs), or birth control pills with synthetic estrogen and progestin, to treat painful periods known clinically as dysmenorrhea.

Of course, pharmaceutical companies that manufacture COCs are probably eager for this research, as prescribing the pill for dysmenorrhea is still an off-label use in the U.S. (unlicensed use in the U.K.). Pill manufacturers may be able to use this finding to lobby the FDA (or equivalent agencies in other nations) to approve the pill as treatment for menstrual pain, leading to increased sales and insurance coverage. Perhaps that’s why news media have been treating this discovery as breaking news.

Take this headline: Yes, the Pill CAN ease the agony of period pain: Scientists confirm what millions of women already know, or this one: The pill ‘does ease period pain’, or this one: Combination oral contraception pills cut menstruation pain, or, really, any of these.

You can read the abstract of the study by Swedish researchers Ingela Lindh, Agneta Andersson Ellström and Ian Milsom, published this week in the journal Human Reproduction, here: The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study. The conclusions are simple: “COC use and increasing age, independent of each other, reduced the severity of dysmenorrhoea. COC use reduced the severity of dysmenorrhea more than increasing age and childbirth.”

Forget the age factor for the purposes of this discussion. The fact that COC use reduces the severity of dysmenorrhea is not astounding. This is old news. So says Dr. Steven Goldstein, an obstetrician/gynecologist at NYU Langone Medical Center in New York City, quoted in a USA Today story:

“The study results are not surprising. It’s gratifying to see researchers documenting scientifically what practitioners have been seeing for a very long time. The amount of discomfort from a woman’s period with a combination birth control pill is a fraction of what it is without the Pill. There is a diminution of pain from the Pill.”

What is astounding is what Dr. Goldstein, and other OBGYNs, didn’t say in responding to the study. That the reason the pill reduces menstrual pain is because the synthetic hormones in the pill shut down a woman’s own menstrual cycle. The “period” women experience when on the pill is technically known as a “withdrawal bleed,” brought on by seven days of placebo pills. While it feels like a period to menstruators, it is not the same physiologically as the period they experience when NOT on the pill. That’s why it doesn’t hurt as much.

The point is, the pill is too often credited with regulating the menstrual cycle. It does no such thing. The pill does not regulate any woman’s menstrual cycle; it supercedes it. This research, and the many news stories that reported it, once again ascribe power to the pill – this time the power to cut menstrual pain. This is an incomplete truth.

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Is Coming Off the Pill a Growing Trend?

January 11th, 2012 by Laura Wershler

The Internet abounds with articles, posts and forum discussions about coming off the birth control pill. Women are looking for information and advice. Many are trying to get pregnant, others are just done with hormonal contraception.

It’s a topic that interests many of us connected to the Society for Menstrual Cycle Research (SMCR) because of

Created at an a menstrual arts and crafts event, Andrea, 25, said this piece depicts the multiple emotions she feels around menstruation. Photo by Laura Wershler

how the pill and other forms of hormonal contraception impact the menstrual cycles of the women who take these medications. Some of us are experts in menstrual cycle function and dysfunction, most are advocates for healthy, positive menstrual cycle experiences from menarche to menopause.

A recent blog post at nomoredirtylooks.com on the topic of quitting the pill caught our members’ attention.  Re: Cycling blogger Elizabeth Kissling included the post in Weekend Links on November 19.

A young woman in Paris was looking for advice and comments from other blog readers about how to manage the effects of coming off the pill. Siobhan O’Connor, the blog co-editor, shared Paris girl’s story with a graceful, inclusive invitation to readers:

There’s no judgment—implicit or explicit—on anyone who is on or has been on birth control pills. Some people love them, some people have to take them for medical reasons, some people abhor them. Here, we want to talk candidly about what happens when you go off them. Because, whoa. That can be hectic.

The post drew over 80 comments, with a few coming from SMCR members. What struck me was how many women:

1)  had already ditched the pill or were planning to
2) expressed a desire for the return of regular, normal menstrual cycles
3)  were concerned about their skin (it often breaks out after quitting the pill).

SMCR member, endocrinologist and guest blogger Dr. Jerilynn Prior answered the concerns about acne and bad cramps in a comment posted on November 22, and included a link to Centre for Menstrual Cycle and Ovulation Research website where readers can find information about all things related to menstrual cycle health.

Holistic Reproductive Health Practitioner Geraldine Matus, another member, commented on November 26 that it was concerns and experiences like those expressed by posters that prompted her and colleague Megan Lalonde to write the guide: Coming Off the Pill, the Patch, the Shot and Other Hormonal Contraception.

I invited No More Dirty Looks readers to visit this blog to learn more about the menstrual cycle and the issues raised by their online discussion.

Regular visitors to re: Cycling know that we cover a broad range of topics, but bloggers frequently address hormonal contraception as it relates to women’s health issues.

Check out this sampling from the re: cycling archive:

Several of the women who responded to the Paris girl post at nomoredirtylooks.com expressed eagerness to reclaim healthy, ovulatory menstruation and a willingness to learn how to  manage their fertility without the aid of hormonal contraception.

Yaz, Yasmin and Ortho Evra patch increase risk of blood clots

December 14th, 2011 by Laura Wershler

Blood clots are a serious, if rare, side-effect of hormonal contraceptives. If left untreated, clots can lead to debilitating, or fatal, strokes. The increased risk of blood clots in users of some hormonal birth control brands has been the subject of several recent news stories.

In early December, Health Canada asked Bayer Inc. to change the labels on Yaz and Yasmin, two of the most popular birth control pills, because use of the drugs is linked to higher rates of blood clots.

According to a November 2011 story at cbc.ca/news, health problems associated with these two drugs include stroke, deep vein thrombosis, pulmonary embolism and heart attack.

The concern surrounds the progestin – drospirenone –  used in Yaz and Yasmin. Although promoted as being associated with less bloating and clearer skin than other progestins, drospirenone is also associated with a “1.5-to-three fold increased risk of experiencing a clot compared to women using other birth control drugs.

What this means in real terms varies from study to study, but one study led by Susan Jick of Boston University found the rate of non-fatal blood clots to be 30.8 per 100,000 among women taking Yaz or Yasmin (the only drugs containing drospirenone) compared to 12.5 per 100,00 among those taking pills containing the older, more common progestin levonorgestrel.

In related news this past week, advisers to the FDA recommended that Johnson and Johnson revise the label on its Ortho Evra birth control patch to better explain the risk of blood clots. Use of the patch has been associated with a higher rate of blood clots for several years. Publicity about the clot risk has no doubt contributed to a 50% decline in sales in the last five years. The formulary problem with the patch is its higher dose of estrogen compared to other pills.

The FDA advisers also recommended more detailed description of blood clot risks for Yaz and Yasmin.

What caught my eye in both stories were the take home messages from those requiring these label changes to women using these drugs.

Health Canada said women should talk with their doctors about the risks and benefits of taking drospirenone-containing oral contraceptives but did not urge women to stop using Yaz and Yasmin.

The FDA’s reproductive health advisers “voted 19-5 that the benefits of the weekly Ortho Evra patch outweigh its risks, including a potentially higher risk of dangerous blood clots that can cause heart attack, stroke and other life-threatening problems.”

I want to know why the five FDA panelists opposed to this decision think the benefits of the patch DO NOT outweigh the risks.

These news stories beg the question:  Should women be concerned enough about the increased blood clot risk associated with Yaz, Yasmin and the Ortho Evra patch to stop using these brands?  If you take these drugs, are you concerned?

If adverse publicity about blood clots resulted in a sharp decline in sales of the Ortho Evra patch, we should expect to see a similar decline in sales of Yaz and Yasmin.

The cbc.ca article reports that the family of a Toronto woman, who died of a large pulmonary embolism after taking Yasmin, has filed the first individual civil suit against Bayer Inc. in Canada. It also states that “more than 10,400 individual lawsuits related to the two pills have been filed in the U.S.”  Not to mention the class action suits related to these drugs currently in progress in both countries.

One thing is certain, the litany of stories about the adverse effects of hormonal contraceptives is not about to end anytime soon. Stay tuned.

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Does the Pill cause prostate cancer?

November 16th, 2011 by Laura Wershler

Of the growing list of reasons why women might want to reconsider using birth control pills, this could well be the strangest.

Researchers at Princess Margaret Hospital in Toronto published a study on Nov. 15  in the BMJ Open Journal in which they found a “strong correlation” between the use of birth control pills and the incidence of prostate cancer worldwide.

One of the possible explanations of how the two are related is the potential impact of the estrogen compound – ethinyloestradiol – that women using the pill secrete in their urine. It has been speculated elsewhere that these endocrine-disrupting substances could end up in our drinking water or get into the food chain.

The Pill, introduced in the 60’s, has been widely used for decades. The study suggests that exposure to these substances over 20 to 30 years could have a clinically significant effect. Researchers said further study of this link is needed.

In 2010 the media was full of stories marking the 50th anniversary of the birth control pill. The Pill at 50: Sex, Freedom and Paradox, rang the headline of a Time Magazine article by Nancy Gibbs. Could rising rates of prostate cancer be part of this paradox?

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I’ll read for the cure, but I won’t drink the pink Kool-Aid

October 19th, 2011 by Laura Wershler

OPINION

Every October it’s the same thing:  Buy pink, think pink, drink the pink Kool-Aid.  All in pursuit of (mostly) the cure for breast cancer.

Forget the cure. I’m much more interested in preventing the disease. As such, I’ve refused for years to walk or run for the cure to breast cancer. Not only am I concerned that too little of the money raised by such events is being spent on prevention research, I also don’t like what can only be called the commodification of breast cancer.  For more on this check out thinkbeforeyoupink, a program of Breast Cancer Action.

In addition to these concerns, I find some of the breast-cancer fundraising and awareness-building activities being promoted this year to be nothing short of cringe-worthy.

I certainly won’t be attending boobyball 10 next month.  This auspicious event is put on by Rethink Breast Cancer, a Canadian non-profit geared to building awareness in the under-40 crowd. Too bad Rethink’s booby fetish seems more appropriate for the under-12 set.

And I won’t be wearing an “I love boobies” bracelet anytime soon.  Nor will students at a middle school in Kelowna, British Columbia, where the bracelets were recently banned because the message was deemed “offensive.” I’d ban the $3.99 over-priced plastic wristbands just for being silly.

The bracelets, along with other silly “I love boobies”  promotional products, are sold by keep-a-breast.org, the mission of which “is to help eradicate breast cancer by exposing young people to methods of prevention, early detection and support.”

Although I’m sure both of these organizations mean well, I want to scream, “Enough already!”  I know I don’t fit either org’s demographic, but still, enough already.

What I will attend, this evening, and with some hesitation, is the inaugural Read for the Cure event in Calgary.  For $90 I’ll enjoy wine and nibbles, hear three Canadian female authors read from their work, and take home three books by these featured writers.

Marina Endicott is one of three featured authors at Read for the Cure in Calgary, Alberta on October 19.

Read for the Cure is a Canadian endeavor launched in Toronto in 2006 by two women from the same book club who had recently completed treatment for cancer.

“Acknowledging the important role of reading in their lives, and the wonderful support they had received from their fellow members during their treatment, they saw an opportunity to harness the energy of enthusiastic book clubs and readers to raise funds for cancer research.”

I love books, I love my own book club, and I’m going to the event with a dear friend whose mother died of breast cancer.

While breaking my self-imposed boycott of cancer-related fundraising events, I plan to ask a few questions of my fellow attendees:

What’s your take on the mammography screening controversy?

Are you aware of the connection between healthy ovulatory menstruation and breast health?

What do you know about vitamin D and cancer prevention?

I’m also hoping to engage representatives from the Alberta Cancer Foundation and the Cancer Research Society — the two recipients of the event’s proceeds — in discussions about the current research projects they’re funding.  Do they know about the Breast Cancer Prevention Study being conducted by Grassroots Health to explore the association between vitamin D levels and breast cancer?

Tonight, my drink of choice will be red wine. Here’s to a fun evening.

 

 

 

 

 

 

 

 

 

 

 

 

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Vitamin D and Early Onset of Menstruation

September 21st, 2011 by Laura Wershler

Could vitamin D deficiency in young girls contribute to early onset of menstruation?  

A study conducted by the University of Michigan School of Public Health suggests this may be the case.  Blood vitamin D levels were measured in 242 girls between the ages of 5 and 12 in Bogota, Colombia. The girls were then followed for 30 months.

“Compared to girls in the vitamin D-sufficient group who first menstruated at the age 12.6 years, those in the vitamin D-deficient group started menstruating at11.8 years. (Epidemiologist Eduardo)Villamor says that although 10 months may seem like a small gap, the difference is momentous because at that age, a young girl’s body may undergo many changes rapidly.”

The findings are significant because of other research suggesting links between early onset of menarche, or first menstruation, before the age of 12 and serious health concerns later in life such as cardiovascular disease and breast cancer. Vitamin D deficiency is also associated with poor bone health and osteoporosis.

This study showing an association between vitamin D deficiency and early menarche raises many questions. Should mothers be asking their doctors to test their daughters vitamin D levels? How might vitamin D supplementation prevent future health concerns now associated with early menarche? What blood level for vitamin D is optimal?

Grassroots Health, a non-profit advocacy organization promoting optimal vitamin D levels for the prevention of disease and maintenance of good health, has recently launched a study on breast cancer prevention with vitamin D. The group also has an initiative called D*Action involving a consortium of scientists, institutions and individuals committed to solving what they consider to be a worldwide vitamin D deficiency epidemic.

Might the girls in Colombia lead the way for vitamin D supplementation to begin at a young age to protect the bones, breast and hearts of the next generation?

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Summer’s Eve Campaign Targets Wrong Body Part

August 2nd, 2011 by Laura Wershler

The print ad for the Summer's Eve campaign refers to the "V" but not the vagina.

If a product manufacturer or its advertising company, or both, cannot figure out which part of the female body their new line of feminine hygiene products can be used for, then both are in big trouble.

There has been much hoopla over the recently launched Summer’s Eve campaign. Links to stories about and response to the campaign can be found in my fellow blogger Elizabeth Kissling’s July 27th post. The most serious backlash to the campaign resulted in three videos perceived as “racially insensitive” being pulled from the campaign website late last week.

What rankles me about the campaign – beyond its patronizing, unsophisticated and euphemistically silly approach to the female genital area - is that it appears to target the vagina when it is clear that none of these products are actually intended for use in the vagina.

Regardless of what one might think about the value of or necessity for these femcare products, an advertising campaign for such products must convey accurate information. Like where to use them.

The product line includes: cleansing wash, cleansing cloths, deodorant spray, body powder, and bath and shower gel. Click on the OUR PRODUCTS box on the website home page and you’ll see this: Meet the products that love your vagina. Oh, really?

These products are not intended, I repeat, not intended for use in the vagina. One would think that the product manufacturer knows this. Why then did they choose a talking vagina, and across-the-board references to the vagina, to convey their product message on the website?

Interestingly, the print and TV ads hold no direct reference to the vagina. The website coyly advises viewers that they can call it “V” for short. It is this moniker and the tagline ” Hail to the V” that crosses over to print and television.

Maybe this was intended as a subtle reference to the other “V” word – vulva . It’s pretty clear this is the body part for which the Summer’s Eve products are intended.

I wanted to know why the creative team at The Richards Group, the ad company responsible for the campaign, chose to use the word vagina instead of vulva. My request for an interview to ask this question was turned down, so instead I asked two colleagues what they thought the reason might be.

Valerie Barr, veteran sexual health educator and training centre manager at Calgary Sexual Health Centre, suspects it’s because vagina is assumed to mean what is actually the vulva. She says, “I believe this assumption, or taken-for-granted use of the term, serves to avoid discussion of the clitoris and therefore, female sexual response.”  Barr says she thinks it demonstrates that in our culture we continue to be unconsciously uncomfortable with women being sexual beings.

Rebecca Chalker, female anatomy expert and author of The Clitoral Truth, also believes that fear of the word clitoris has much to do with it. ”Clitoris is the most toxic word in the English language, and to this day is considered obscene and too offensive to be used in the media. Just try it on people,” she says.

“Eve Ensler (author of The Vagina Monologues) made the vagina safe for the general public – even she did not use the C–word. Vagina has now become the default reference for everything ‘down there.’ Those ad guys are no different. Perhaps they’re just using the default because that’s what they think people can relate to most readily,” Chalker says.

Although vulva is the accurate word to describe the female body part intended to benefit from the Summer’s Eve product line, Chalker says, “It would be a tragedy if vulva becomes the new default. In anatomical parlance vulva just means covering.”

“Think Before You Pink”

October 1st, 2010 by Laura Wershler

breast cancer actionIt’s October again: breast cancer awareness month.  Women’s magazines are featuring stories about breast cancer, charitable events all over North America are raising money for breast cancer research, and retailers are urging you to shop to cure breast cancer.  

Read those stories, run for the cure, but – at the behest of Breast Cancer Action - think before you pink.  National chains and brand names aside, some of the more questionable vendors, hawking wares to consumers, leave one wondering how breast cancer became such ”big business”.  Who will want a cure, or effective prevention strategies, if it will mean putting a lot of people out of work? Including manufacturers who make mammography machines, and pharmaceutical companies that focus on breast cancer drugs.

Breast Cancer Action positions itself as ”the watchdog of the breast cancer movement“. They are the only national breast cancer organization in the United States that does not accept money from any source that profits from breast cancer. Their position on shopping in support of breast cancer awareness is clear:

Think Before You Pink™, a project of Breast Cancer Action, launched in 2002 in response to the growing concern about the number of pink ribbon products on the market. The campaign calls for more transparency and accountability by companies that take part in breast cancer fundraising, and encourages consumers to ask critical questions about pink ribbon promotions.

This October, consider carefully how you will demonstrate your breast cancer awareness.  “After all”, as Breast Cancer Action notes, “ if shopping could cure breast cancer, it would be cured by now.”

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Libido and the Pill

September 7th, 2010 by Laura Wershler
Laura Berman, Ph. D.

Laura Berman, Ph. D.

It’s great to see celebrity sexpert Laura Berman, Ph. D. – frequent Oprah TV guest, Oprah radio host, and (according to her website) world renowned sex and relationship expert - talk truth about the effect of the birth control pill on women’s libido.

In the September 2010 issue of Parenting magazine, Dr. Berman acknowledges that the pill can lower libido and clearly explains the mechanisms for this.  So far so good. What bothers me is her advice to moms experiencing this problem.

Happily, there are solutions, short of becoming celibate. Here are four options— talk to your doctor to see if any of them might be right for you.

Her recommendations include two alternative forms of hormonal contraception –  the Nuvaring and the Mirena IUD, the hormone-free IUD, and a sterilization method called Essure that scars the fallopian tubes to prevent sperm reaching egg.

Granted, all are legimate alternatives to the pill.  But the message sent, yet again, is that women who don’t want to get pregnant or remain celebate must depend on drugs, foreign objects inserted into the uterus, or sterilization.  If nothing else is mentioned, then nothing else must be trustworthy.

It has become all too typical for sexual healthcare providers to ignore the needs of women seeking information, support and services to use non-hormonal, non-invasive methods of birth control confidently and effectively.  This was a golden opportunity for Dr. Berman to talk about the ever effective condom, the new FemCap cervical barrier, and the growing interest amongst American women in Fertility Awareness Methods, which though wildly misunderstood by most in the medical and sexual health community have proven effectiveness equal to the pill.

Kudos to Laura Berman for telling the truth about the pill and libido.  Many sexual health care providers are not this open about the libido lowering effects of oral contraceptives.  Check out the comments at this May 2010 discussion at Jezebel.com about the subject.

Now I urge Berman to take on the challenge of providing information and support for women who are ready to turn the page on hormonal and invasive birth control methods.  For some women it will be the only way to achieve the better sex and intimacy at any age she promises on her website.



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Tonight’s the Night: Listen to Seeing RED

June 14th, 2010 by Laura Wershler

Tonight’s the night, Monday, June 14th, to tune in as CBC Radio airs Part One of: Seeing RED: A Cultural History of Menstruation This two part documentary concludes next Monday, June 21st. If you miss the original broadcast, which you can listen to online at 9:00 PM in all time zones (choose the program IDEAS) you will be able to link to the podcast at any time convenient to you as of Tuesday, June 15th.  SHAA SEP 07 029

Introduction to the documentary:

They are misfits. Witches. Children. Just a few of the labels used to portray menstruating women over time. The Bible has described the bleeding woman as undergoing “customary impurity”. In the Middle Ages, it was thought that women menstruated to release “sexual overflow”. Their counterparts in the Victorian era were told that a period would deplete their body’s precious resources. Twentieth century feminists worked hard to reclaim menstruation as a vital and positive part of womanhood. IDEAS producer Mary O’Connell explores menstruation from a cultural and historical perspective.

Several members of the Society for Menstrual Cycle Research were interviewed for this documentary. We invite our readers to listen to the program and share their thoughts and comments.    (Photo by Laura Wershler of Bleedy, the Period Puppet, created by Bree Horel at a Menstrual Arts and Crafts event held by Sexual Health Access Alberta.)

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Teens Using the Rhythm Method? It’s Time for Body Literacy

June 8th, 2010 by Laura Wershler

Cycle SavvyTeen sex: More use rhythm method for birth control.

It was an odd headline for an Associated Press story on the 86 page report on teen sexual activity just released by the Centre for Disease Control and Prevention. Not all that relevant to the broader subject of the study on which the report is based: Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, National Survey of Family Growth 2006-2008. If you’re interested, it is a fascinating read.

But it was the headline and this excerpt from the story that caught my attention:

About 17 percent of sexually experienced teen girls say they had used the rhythm method – timing their sex to avoid fertile days to prevent getting pregnant. That’s up from 11 percent in 2002.

They may have been using another form of birth control at the same time. But the increase is considered worrisome because the rhythm method doesn’t work about 25 percent of the time, said Joyce Abma, the report’s lead author. She’s a social scientist at the CDC’s National Center for Health Statistics.

You can’t study what you don’t understand. The study authors demonstrate their lack of knowledge about natural birth control methods by the question they asked study participants:  Have you ever used rhythm or safe period by calendar to prevent pregnancy?

There are many brands of natural birth control. Some , like the Rhythm and Calendar methods, are not effective. No proponent of Natural Family Planning (NFP) or Fertility Awareness Based Methods (FABM), which have effectiveness rates as high as 99.4 percent, would recommend them.  Yet this study does nothing to differentiate between these methods of natural birth control, thereby confusing the public, the study results and themselves.

It’s high time researchers studied up on natural birth control methods if they want to include questions about them in a study on the contraceptive practices of teens or adults.

Until they do, I suggest anyone interested in the sexual and reproductive health of teen girls start buying copies of Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body.  This book can help our daughters acquire the life skill of body literacy – to understand the mysteries of their menstrual cycles and how this knowledge can serve them well as they make decisions about their sexual and reproductive health and lives.

 

 

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SMCR Bloggers Respond to ACOG’s Homage to the Pill

May 20th, 2010 by Laura Wershler

MenstruationResearch.org – Today, during an email exchange among the Society for Menstrual Cycle Research blogging team, research-advocacy experts on the menstrual cycle spoke out in response to the unbridled passion for the pill expressed by members of the American College of Obstetricians and Gynecologists at their 58th Annual Clinical Meeting. Amidst the hoopla surrounding the 50th anniversary of the pill, it must be noted that not all experts believe the pill to be an unequivocally positive contribution to women’s health and well-being that those quoted in the ACOG media release purport it to be.



“The pill has literally changed the world, and it was a primary stimulus to the women’s movement of the 60s. It has done far more for women’s rights than any legislation that has been passed and should be recognized as the great emancipator of women.”


Mark S. DeFrancesco, MD, MBA, Cheshire, CT
Secretary Elect, The American College of Obstetricians and Gynecologists

“When the pill first came out, young unmarried women had to fight for the right to take it. Now, they have to fight for the right NOT to take it. Overhyped as medicine’s gift to women’s health, by mostly male gynecologists who have never taken the drug, the pill has become an almost forced right of passage – the “standard of care” treatment for being a girl. Emancipation or subjugation? Ask the young women who face coercion and control by their doctors when they ask for support to use non-hormonal methods of birth control.”

Laura Wershler, Sexual Health and Reproductive Rights Advocate,
Executive Director, Sexual Health Access Alberta


“Birth control pills provide women with many non-contraceptive benefits, including cycle control, cancer prevention, and pain relief. They have been an integral part of women’s health.”

Scott D. Hayword, MD
Mt. Kisco, NY
Chair, District II, The American College of Obstetricians and Gynecologists

“Birth control pills provide women with many risks in exchange for contraception, including blood clots, stroke, breast, cervical, and liver cancers, diminished libido, and mood disorders. They have been instrumental in activating the women’s health movement, as feminists
demanded responses to these risks.”

Elizabeth Kissling, Ph.D.
President, Society for Menstrual Cycle Research


“I have often thought that the birth control pill should be called a hormone regulation pill because its use and impact have been so much broader than contraception alone. The pill has certainly improved reproductive control, but the impact on menstrual regulation has been very important for women, from adolescence to menopause.”


Jeanne A. Conry, MD, PhD
Roseville, CA
Chair, District IX, The American College of Obstetricians and Gynecologists

“I’m so happy to have The Pill called “a hormone regulation pill” because that is the way it is currently used by many physicians, and some women. It is used to cover up the far-apart cycles of anovulatory androgen excess (also known as PCOS) but doesn’t promote ovulation. The Pill is used to treat heavy bleeding in teenagers, but doesn’t restore her own balance of estrogen and progesterone. It is used for menstrual cramps when ibuprofen or other non-steroidal is more effective and has no suppressive effect. It is used to treat premenopausal osteoporosis when the evidence suggests it causes rather than prevents subsequent fragility fractures.

In short–the Pill has become the major non-surgical tool of gynecology.”

Jerilynn C. Prior, MD, FRCPC
Professor of Endocrinology / Department of Medicine
Centre for Menstrual Cycle and Ovulation Research
University of British Columbia

“The introduction and rapidly accepted, widespread adoption of oral contraceptives among women of reproductive age drastically reduced women’s fear of unplanned pregnancy in ways their mothers and grandmothers never knew. The pill has allowed women to take different roles in all aspects of their lives—career, education, travel, and a host of other beneficial ways.”

J. Craig Strafford, MD, MPH,
Gallipolis, OH
Vice President, The American College of Obstetricians and Gynecologists

“Women realize their full potential when they are supported in making informed decisions in all aspects of their lives. Indeed, oral contraception has enabled women to avoid unplanned pregnancies, but it has never been a risk-free option. While providers are eager to prescribe the pill, they are less eager to fully explain how hormonal contraception works and the side effects it carries. Until women have access to a full range of safe, affordable and accessible options, their freedom is compromised.”

Chris Bobel, Ph.D.
Chair and Associate Professor of Women’s Studies, University of Massachusetts-Boston

“The pill has revolutionized women’s health care. Obviously, the contraceptive benefits are paramount, but I have become a huge advocate for all of the non-contraceptive reproductive health benefits that the pill offers. Another advantage is that the pill has enjoyed incredible safety over its 50-year history.”

Douglas H. Kirkpatrick, MD, Denver, CO
Immediate Past President, The American College of Obstetricians and Gynecologists

“The Pill has its roots in a time much farther back than fifty years.
Historically the female body has been feared and the release of the
Pill fitted very easily into this history. Victorian doctors removed
women’s ovaries in response to many perceived female problems, and today doctors prescribe the Pill, shutting down ovulation. The Pill is not only prescribed for birth control – it is handed out to women with acne, PMS, irregular periods, heavy periods. Even light, regular periods are now considered enough of an inconvenience to warrant a long-term drug dependency. The Pill has developed into a medication for the disease of being female. In place of changing society, society decided to fix women. At a time when we are more concerned about what we eat, what we wear, what we use to clean the toilet than ever before, we are still celebrating millions of otherwise healthy women taking a powerful medication every day, for years.”

Holly Grigg-Spall, Journalist

“The advent of effective contraception was revolutionary, transforming, empowering, and a tremendous boost to women’s health. It continues to play a major role in the effort to achieve responsible reproductive health and choice for all women—a goal of every child being a wanted child delivered into a supportive and secure environment.”

James N. Martin, MD, Jackson, MS Secretary, The American College of Obstetricians and Gynecologists

“If the pill was as revolutionary, transforming and empowering as is suggested, then all women should be taking it from menarche to menopause, except when we are ready to have the “wanted child.” But we aren’t. Today, young women are ditching the pill in favor of non-hormonal methods, and still managing to achieve responsible reproductive health choices. As for the pill being ”a tremendous boost to women’s health” – I think not. Troublesome side effects, serious health concerns, and a growing interest in holistic approaches to health care are putting the pill in its proper place. One contraceptive choice that works for some women, some of the time.”

Laura Wershler, Sexual Health and Reproductive Rights Advocate,
Executive Director, Sexual Health Access Alberta


“The pill is probably the single biggest contribution to women’s health in our lifetime. Not only has it given women more control over their fertility, it has been successfully used to treat many gynecologic conditions such as dysmenorrhea, menometrohaggia, PMS, acne, PCOS, and endometriosis, enabling women to have a better quality of life.”


James A. Macer, MD, Pasadena, CA

Assistant Secretary Elect, The American College of Obstetricians and Gynecologists


“Long term safety data on the current patterns of use of the pill do not exist, and are not being collected. When first approved, the pill was available to married women, most of whom had children, and allowed them to space their families. Currently, the pill is most commonly used by childless young women, often during the teen years, and can extend for decades. The consequences of pharmaceutical suppression of the developing endocrine system (during the 12 years following the first period) have, to my knowledge, not been explored. For example, taking the pill interferes with bone acquisition, compromises the accumulation of bone density, and may compromise peak bone mass. Peak bone mass sets the bar for lifelong bone health. In a cohort expected to live into their 80’s, casual and enthusiastic use of the pill may be something society regrets half a century from now. There is a tendency to blame side effects on the bad old days, and to say that things are better now. But a recent large study confirmed blood clot risks with today’s “modern” formulations, and, more worryingly, these risks are amplified by obesity and smoking, both of which are more prevalent in modern populations.”


Christine L Hitchcock, PhD, Research Associate, Centre for Menstrual Cycle and Ovulation Research, and Clinical Assistant Professor, School of Population and Public Health, University of British Columbia

This ACOG statement furthers a broader message to young women that they should trust pharmaceutical menstrual rhythms over that of their own bodies and that they should trust clinical authority over their own authority. In and of itself, ceding their bodily authority, ownership and stewardship to medicine causes harm to women.

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The Society for Menstrual Cycle Research is a nonprofit, interdisciplinary research organization. Our membership includes researchers in the social and health sciences, humanities scholars, health care providers, policy makers, health activists, and students with interests in the role of the menstrual cycle in women’s health and well-being.

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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.