Saturday, September 26, 2009

In the news

Today the New York Times contained an article entitled 'Health Concerns Over Popular Contraceptives' which suggests the pharmaceutical company Bayer is heading for some serious trouble over its pills Yasmin and Yaz. Alongside the mounting law suits claiming these pills have caused blood clots and strokes in a large number of women, researchers are now speaking out on a matter that's been rumbling for a while - that all third generation pills containing new progestogens might hold a higher risk of causing such health problems.

On top of that, the Food And Drug Administration in the US had to intervene when Bayer was found to not be following correct quality control procedures at its pill manufacturing factories. The piece starts by highlighting the promotion of Yasmin and Yaz as 'quality of life treatments' and ends suggesting women would be right to switch to a pill containing levonorgestrel, an older progestogen. Microgynon is one, but you can consult the ladder graph linked to in an earlier post where I also remarked that pills containing this progestogen are always the recommended first choice. As a result of the marketing of Yasmin and Yaz, they have become what the New York Times describes as 'go-to drug brands' for young women, overriding this advice.

Here's a link to the article - I have a feeling this marks an important step in changing attitudes towards the birth control pill.

I've been reading Bernard Asbell's 'The Pill: A Biography Of The Drug That Changed The World.' The first few chapters are full of first person accounts from women who were helped during the preliminary years of family planning clinics - women made sick by pregnancy after pregnancy after pregnancy - who physically and mentally couldn't bear any more children. Seeing what a world the birth control pill rose up out of, why it was so desperately wanted and why as a consequence it became so popular has helped me to understand more clearly why this is such a tangled issue.

In the first part of the 20th century little was known about the female reproductive system, relations between men and women were imbalanced to say the least, and procreation was enthusiastically encouraged. I realise that my writing here could seem ungrateful in the face of the suffering endured by women then, but I hope I have been clear that I feel the situation is very different now and believe the pill has run its course as the 'go to drug' for women. I know I live luxuriously - I can discuss possibilities for birth control, read about the options and discuss them with my partner. Which brings me to my next, as yet undiscussed point.

That is, the matter of birth control in developing countries. There are women who live right now in situations very similar to those of early 20th century America. Places where dying during childbirth is a very real risk, where having another child could mean you'll go hungry. There has been little coverage on the way birth control is managed in these countries, but the contraceptive injection Depo Provera and the implant Norplant are widely administered. The effects of these hormone-based options last for months. The pill is not as popular, the authorities distributing birth control likely believe women will not take it as prescribed or keep coming back to collect packets.

A recent study showed 88% of women in the US forget one to three pills a month. The manufacturers of Depo Provera have said that if 7.7% of women had the injection rather than taking the pill the number of unplanned pregnancies would be reduced by 70,000 a year. There are around 400,000 in total annually.

Depo Provera isn't just popular in developing countries - in the US one in five black teenagers have the injection every three months. This is a far higher number than in the white population.
In response to concerns over the injection's side effects - particularly loss of bone mass, increase in risk of cancer development and the long term impact on fertility - the pharmaceutical company Pfizer have recently developed a different, updated version of the drug.

Depo Provera has long been used in Sweden, Denmark, Canada and eight US states for the chemical castration of paedophiles and sex offenders. Basically, it handily wipes out testosterone. The injection used in developing countries and on one in five black teenagers is the same as that used on sexually disturbed prisoners.

The development of the pill was sped up by a calculated change in the debate - rather than pushing for women's sexual liberation those behind the drug presented it as a cure for the overpopulation problem - a far more acceptable argument to audiences then. And, it seems, now.

"The issue was whether any woman would take a pill every day to prevent the chance that she might get pregnant. They believed nobody's going to do that, not when they're not sick, and they're not sick!" James Balog, science trained financial analyst.

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