Blog of the Society for Menstrual Cycle Research

A Pill for Men – Still Five Years Away

July 2nd, 2010 by Elizabeth Kissling
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Photo by Flickr user be_khe | CC 3.0

The Internet, especially the feminist blogosphere, is all abuzz this week with the promise of a new contraceptive pill for men within the next five years. But researchers always say a pill for men is just five years away, according to University of Washington medical professor John K. Amory.

The spark of new hope stems from an interview with Professor Haim Breitbart of Israel’s Bar-Ilan University, published June 28 in London’s Telegraph. Breitbart promises a monthly pill, free of side effects, for men. The Telegraph says human trials are scheduled to begin next year.

How does this proposed pill work? The answer lies in a breakthrough paper Breitbart published four years ago, in which he and his colleagues announced a new discovery about how sperm cells create new proteins after ejaculation, while hanging around in the uterus before fertilization can take place. Breitbart believes that if this protein production process can be derailed, conception can be prevented without hormones. He calls his chemical concoction the Bright Pill (a twist on his name).

Should the pill be available over-the-counter?

June 25th, 2010 by Elizabeth Kissling

The New York Times published an op-ed piece a few days ago about making the birth control pill available without a prescription. Kelly Blanchard, president of Ibis Reproductive Health, offers the following rationale:

Women don’t need a doctor to tell them whether they need the pill — they know when they are sexually active and want to avoid pregnancy. Pill instructions are easy to follow: Take one each day. There’s no chance of becoming addicted. Taking too many will make you nauseated, but won’t endanger your life, in contrast to some over-the-counter drugs, like analgesics.

I have mixed feelings, myself. I’m in favor of just about anything that makes contraceptives more accessible to the people who need them, but I fear that the likely increase in cost of OTC pills means the availability won’t benefit those who most the need them – the young and the poor. Also, there are some contraindications for pill use, such as high blood pressure, history of migraine, and use of certain anti-seizure drugs for epilepsy. And despite the happy, shiny images of Yaz and Seasonique commercials, some women just can’t tolerate the side effects, for any number of reasons.

What do you think, re:Cycling readers?

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Pill Protests – It’s About the Environment

May 25th, 2010 by Elizabeth Kissling
Empty birth control pill packet in the street

Photo by Gnarls Monkey // CC by 2.0

A whole bunch of anti-choice political organizations are co-sponsoring a national protest against birth control pills, but they say it’s not about killing babies or controlling women; it’s all about the environment!

The following is released by the American Life League and the following groups:

WHO: American Life League , Human Life International, Pro-Life Wisconsin, Pharmacists for Life International, Archdiocese of Mobile Respect Life, Operation Rescue, Jill Stanek, Generation Life/Brandi Swindell, Life Education Ministry, Pro-Life Unity, Movement for a Better America, AMEN (Abortion Must End Now), Pro-Life Action of Oregon, Children of God for Life, Expectant Mother Care/Chris Slattery, Mother and Unborn Baby Care, Defenders of the Unborn, California Right to Life Education Fund, Delaware Pro-Life Coalition, Life Guard, Homeschoolers for Life, Focus Pregnancy Center, Central Texas Voices for Life and Dubuque County Right to Life

WHAT: Protest the Pill Day 2010: The Pill Kills the Environment

This year, birth control advocates are celebrating 50 years of decriminalized hormonal contraceptives. American Life League and our co-sponsors don’t think half a century of contaminating our waterways is something to celebrate. Study after study has shown that hormonal estrogen in the water has severely damaged the ecosystem and our health.

Join American Life League and co-sponsors as they launch the largest nationwide protest against the birth control pill.

You know what, American Life League? ALL prescription drugs, not just birth control pills, contaminate our waterways, both through human excretion and production waste. And some of that “hormonal estrogen” is from the hormone supplements taken by middle-aged women. Are you protesting hormone “replacement” therapy, too?

[via Miriam at Feministing]

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How the Pill Gave Birth to the Women’s Health Movement

May 25th, 2010 by Elizabeth Kissling
Photo from http://www.flickr.com/photos/blmurch/486046904/  // CC BY 2.0

Photo from http://www.flickr.com/photos/blmurch/486046904/ // CC BY 2.0

Only a latter-day Rip Van Winkle could avoid knowing that this month marks the 50th anniversary of the FDA’s approval of Enovid, the world’s first birth control pill. Hundreds of newspaper and magazine articles have marked this anniversary.

Many incorrectly credit the pill with giving birth to feminism. As Elaine Tyler May notes in the current issue of Ms., the pill didn’t start the feminist movement but was in the right place at the right time:

The timing could not have been better. The feminist movement gained momentum just as the Pill became available. With the ability to control their fertility, women could take full advantage of new opportunities for education, careers and participation in public life.

But in the midst of all this celebrating, we’ve neglected another anniversary: 2010 marks the 40th anniversary of U.S.  Senator Gaylord Nelson’s congressional hearings about the pill’s safety profile, which arguably did launch the women’s health movement.

How to overcome resistance to Cycle-Stopping Contraception (a physician’s guide)

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.

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“Why I’ll never take the pill again”

May 11th, 2010 by Chris Hitchcock

In an article in today’s Independent, Holly Grigg-Spall presents an alternative to the current celebrations of the pill. It’s an important message to add to the collective contemplation of what the pill has meant to women and to women’s lives, and interesting reading. The pill prevents pregnancy, but not everyone likes how they feel when they take it, and women’s experiences are often not heard or dismissed. In a world where proponents of the pill see it as a cure for all things menstrual, and recommend it as therapy for the painful cramping that the majority of teenagers experience, it is important to also say that there are significant side effects for some women that affect quality of life.

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50 years of The Pill

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?

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The Pill in the News

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.

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What do vaginal rings and tampons have in common?

April 22nd, 2010 by Elizabeth Kissling

Vaginal ring held up for display in gloved right hand.

So here’s an odd little study: when women are given a choice between oral contraceptives and the contraceptive vaginal ring, what characteristic is most highly correlated with a slightly greater interest in using the vaginal ring? If you said “tampon use”, you’re right!

Among contraceptive vaginal ring and OCP users, 247 (79%) reported using tampons. Contraceptive vaginal ring users were not significantly different from OCP users in terms of age, race or ethnicity, marital status, insurance, body mass index, or parity. Adjusted analysis indicated that tampon users were more likely to choose the contraceptive vaginal ring instead of OCPs.

The study was published this month in Obstetrics & Gynecology. The researchers conclude, “but all women should be offered the contraceptive vaginal ring regardless of experience with tampon use”. No kidding. Sadly, they don’t appear to be offered any non-hormonal contraceptive options, as this research was conducted in conjunction with The Contraceptive Choice Project, described in the research report as “a longitudinal study of 10,000 St. Louis area women promoting the use of long-acting, reversible methods of contraception and evaluating user continuation and satisfaction for all reversible methods.”

It seems to me that the researchers want to predict contraceptive choices based on how willing contraceptive users are to touch their own genitals, but apparently they can’t directly ask them. They might accidentally discover an interest in using a diaphragm or cervical cap!

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Does your birth control method stop your cycle?

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.

What’s Up with Yaz?

April 3rd, 2010 by Elizabeth Kissling

Yaz box and pill pack.We’ve mentioned Yaz and its sister drug Yasmin before, and our friend Holly Grigg-Spall tracks the progress of complaints against them and other oral contraceptives. Yaz and Yasmin were Bayer’s top-selling drugs in 2008, bringing in about $1.8 billion, a 17 percent increase from 2007. The key element that makes them different from other OCs is drospirenone, a new form of synthetic progestin which has a pharmacological profile that is reported to be closer to the human body’s own progesterone but a safety profile that has come under scrutiny since the FDA approval of Yaz/Yasmin. Last fall, Bayer revealed that they were fighting 129 lawsuits over side effects and marketing of Yaz and Yasmin. More suits have since been filed.

So with this context in mind, it was with great interest that I noticed this study in my periodic searching of menstruation research literature: Bleeding patterns and menstrual-related symptoms with the continuous use of a contraceptive combination of ethinylestradiol and drospirenone: a randomized study, published in last month in Contraception. It’s a small study, only 78 women over six months time, but the researchers conclude: “Continuous use was associated with amenorrhea and fewer menstrual-related symptoms compared to cyclic use.”

It looks like Yaz and/or its analogues are being tested for marketing as menstrual suppression drugs. Time to put in an interlibrary loan request to get my hands on the full study. Anyone want to place bets on how the study was funded?

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So the pill won’t kill me; what’s the point?

March 18th, 2010 by Laura Wershler

Women on the pill live longer. So touts a March 12, 2010 Reuters news story out of London, England reporting on a study published March 11 in the British Medical Journal (BMJ). A misleading headline if ever there was one.

The study followed 46, 000 women for up to 40 years, to see if the mortality risk among women sho have used oral contraceptives differs from that of never users. What the study actually found, according to the public release issued by BMJ on March 12 is this: “Women in the UK who have ever used oral contraceptives are less likely to die from any cause, including all cancers and heart disease, compared with never users.”

The study also found a slightly higher risk (of death, I presume) in women under 45 years old who are current or recent users of the pill.  As such, the authors assert:

Many women, especially those who used the first generation of oral contaceptives many years ago, are likely to be reassured by our results.  However, our findings might not reflect the experience of women using oral contraceptives today, if currently available preparations have a different risk than earlier products.

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.