Friday, October 30, 2009

Wounded

"To bleed every month - what could be a greater sign of frailty?"

After winding my head around worries of emphasising the importance of women's biology and how that emphasis could be misinterpreted in my last post I handily realised I'd picked up a book called The Frailty Myth by Colette Dowling a couple of months back. Turns out it was just what I needed to do some more figuring.

I haven't been feeling too great lately, certain feelings have really reminded me of my experience with Yasmin. Vulnerability I think is the best word for it - this sense that I am standing on a tiny ledge and any movement might throw me off the edge. I was having trouble understanding why my mood had turned so abruptly and was putting it down to some kind of homesickness or the changing seasons until I talked to a friend who came off the pill a year ago after having similar problems to me. How she explained her mood during the post-pill taking months was very familiar. She described it as having the strong pull of "intuition, but intuition gone wrong" and this meant paranoia building into a constant hum of dread.

I felt, as she had, that I should be wary and suspicious of all that had before brought comfort and happiness. It's like getting physical messages of danger that are telling you to hide or run, but nothing really has changed since last week. A doomed feeling, like how you feel if something bad really does happen and you go to sleep and in those moments of waking up you forget the details of what happened but just know to the point of physical feeling that something is not right. My friend said at the time she felt she was "losing herself" and had no moorings, no foundations for knowing how she should normally be feeling.

I know here I've talked a lot about how the pill can effect your mood when you are taking it, but when coming off it's like stopping any drug you've been on forever - your body gets thrown off and takes time to readjust. Except with this drug your emotional state has been supported by chemicals for so long, you have to battle both with the new natural emotions and the withdrawal symptoms. It's enough to make you want to start taking it again to at least have that crutch. Even your returning libido can feel very odd at first, especially if you started the pill as a teenager and realise you had no clue how that actually felt. It's almost like you don't know how to deal with this new, distracting intruder on your thoughts.

I have got a number of messages from women recently with a similar undercurrent - they thought their depression or anxiety was down to the pill but could think of other outside reasons - a relationship, a job - that might also be a source of worry. This is completely right, the pill can be with us for over a decade of our life and in life stuff happens to make you sad and angry. Even these last weeks I didn't immediately think the issue lied with the pill, I looked elsewere - and that's good, but it's also good to know now that it might not just be me. I often visualise a ship tied to a dock when thinking about the difference between my moods on the pill and my moods naturally - on and off the pill the sea can be rough and choppy, but on the pill that anchor is no longer there. Off the pill however rough it gets there's still that mooring, that solid land.

Anyway, back to that starting quote. Colette Dowling discusses in her book the ideas around women being weaker than men due on their biology, their reproductive system specifically. In the last post I acknowledged that talking about women's biology had these negative connotations because of how we culturally view women's bodies. In talking about the importance of the ovaries, the hormones, I didn't want to suggest women were slaves to this system as I understood historically that idea was used to undermine women's potential and abilities. The Frailty Myth argues it's title - that the assumption that women are weaker and less physically able than men is wrong and if women believed this themselves they could harness their strength and feel more trust in their bodies.

The myth of women's inherent weakness has been used to rationalise their inferiority in the eyes of society. The inequality between the sexes was explained away in one way or another by the fact that women are different - that their bodies prevent them from doing everything men do with equal success. Colette Dowling argues that each time in history women have demanded more rights, more power their attempts have been undermined by purportedly scientific understandings of the restrictions of the female body. She believes these scientific understandings to be false, only myths believed for so long they are taken as truth despite the lack of evidence in support and the mounting evidence to the contrary.

She argues that confidence in your body is essential to good mental health, well being and self-fulfillment. I've talked before about not trusting my body, seeing it as suspicious and out to betray me with periods or pregnancy, so this really struck a chord. Colette Dowling is very much for women's sports, and developing your body through exercise which I totally understand but even if you are not that sport-orientated shall we say, this idea of having confidence in your body still makes sense. She sees exercise and sports training as a way of taking pleasure in the capacity of your body to do anything you decide to accomplish. Rather than being about losing weight and keeping thin, it's about being healthy and strong.

The frailty myth is in her words "the emotional and cognitive equivalent of having our whole bodies bound." It's interesting to consider how the pill can lead to women feeling weaker and fatigued because of its effect on nutrient metabolism and testosterone levels (amongst other problems). Also interesting is how we've come a long way from thinking of having a monthly period as a sign of good health. If you're not on the pill and you don't have periods it's assumed something is up. The routine of the pill and the one week off for every three was originally a marketing device as it was thought women would be unhappy with the idea of never having a period.

Victorian women were encouraged to behave as though they were sick and then they did so convincingly that they got sick. They were not allowed to do anything, to exercise, engage their minds and this made them ill. We still live with these floating theories that we need to protect out fertility through inactivity and that menstruation is disabiling. The pill of course stops menstruation and is often said to 'protect' our fertility by decreasing the risks of ovarian and uterine cancer development. We have come to believe we are meant to not only be emotionally unstable but also weak and passive. So if we don't feel good on the pill, we don't recognise this because its effect reinforces how we think we are supposed to be.

If we remove the negative assumptions and myths surrounding women's bodies then we can talk freely about the relation of the hormone cycle to moods and well being. I read something by Maureen Dowd yesterday - women might be 'hormonal' once a month, as in PMS, but men appear to have hormones raging all day every day and their resulting moods are seen far more positively. Not just about difference then, but also similarity when we stop seeing hormones as exclusively a women's problem and instead see the body's cycles as crucial to being a living human being.

Friday, October 23, 2009

Muted

I'm coming to realise that when you start talking about how women are different from men you open yourself up to all kinds of problems. I've been trying to figure out the reasoning behind women's reluctance to criticise the pill in any way larger than sharing concerns between friends. As part of my figuring I've naively wandered into a trap that could undermine my motivation here. Still reading Faludi's 'Backlash' I came across this statement that brought clarity to an idea I suppose I've been kicking around already without noticing.

"Examining gender differences can be an opportunity to explore a whole network of power relations - but so often it just becomes an invitation to justify them."

I see that talking about how women have a different biology to men, and particularly that they have hormone cycles that effect their moods can be seized upon as support for ideas that I don't believe in at all. Ideas that categorise women as frail, weak, irrational - handicapped by their biology. If you emphasise the importance of the uterus and ovaries too much, it can be taken to be suggesting women are ruled by these organs. Even if you're positive about the hormone cycle and the good it can bring, rather than discussing it negatively, you are still seen to be bolstering the historically destructive understanding that women are irrational, where men are rational and women are ruled by the body, where men have the mind. Even suggesting women have instincts, or that they can be more creative, or more productive, at certain times is easily misconstrued.

'Backlash' discusses one writer Carol Gillagan whose 'In A Different Voice' was attacked for bolstering arguments that independence and freedom were inherently unhealthy states for women. Another writer, Dr Toni Grant claimed 'Biology is destiny,' creating a thesis that somewhat accidently backed up the long-standing belief that feminism had led to professionalism which had in turn led to psychosis.

I can see now why women tread so carefully around the issue of the pill. There's a fear of drawing attention to the action of the pill and the problems it might cause when everything bound up with that is so complex. Much effort has gone into playing down the differences between men and women in order to get women an equal standing. I'm not saying women have had to pretend to be men, I'm not even sure how comfortable I am with the dichotomy of what being a 'man' is and what being a 'woman' is, only that we've had to keep quiet on certain issues so as to not reopen an already battered can of worms.

Perhaps it's that women know that the reason doctors doubt them when they complain of panic attacks and anxiety when taking the pill is that those doctors, and society in general, believe being 'emotional' is intrinsic to being female.Complaints about feeling 'out of control' of our emotions are therefore not taken seriously as it's presumed we always feel that way. Like that idea that women are masochistic that I spoke of in an earlier post, there's also this connecting idea that we are all, always miserable. This oppressive assumption - everywhere once you start looking - stops women recognising the negative impact the pill often has on their well being, as much as it stops doctors believing that the pill can have such an impact.

I've heard a couple of interesting comments recently regarding men's moods. New research is showing that men experience cyclical moods in a similar way to women. I'd be interested to find out more about that, although I don't think it needs to be scientifically proved in order for what I'm saying here to have justification. If women weren't taking the pill, I'd think it was absolutely fine for them to go ahead and ignore their monthly cycles and forget they even exist for three weeks out of four. But as many of them are taking the pill I think it's important they are aware of what their body would naturally be doing otherwise. That way they can decide if they want to use this kind of contraception and realise when it's making them unwell. I don't think women should be hiding what's going on every fourth week either - it just would be healthier if we consider other ways of preventing pregnancy.

In fact, no whitewashing here - it's been six weeks since I stopped taking the pill and the first signs of my body rumbling back to life have not been much cause for celebration. It feels more like the first party an alcoholic has to attend after giving up the drink. A test of my will. I have had a pain in my side for two days straight which I am taking to mean ovulation and not appendicitis. My skin and hair have taken a downturn for the worse, with testosterone levels picking up rapidly the confusion seems to have sparked off a sebum production frenzy. Now, I should and will welcome a major decline in attractiveness for the time that my body takes to work out what the hell is going on, considering it comes with a lack of extreme emotional upheaval. However, I can't help looking back slightly fondly to my beautifully clear Yasmin-induced no-testosterone-whatsoever skin. See, it's a tough enough fight for me.

My libido is slowly stumbling upwards, like someone woken suddenly in the middle of the night. It's pretty fascinating to physically experience all the stuff I've been writing about. If you think of the skin and hair situation in marketing terms it's like this useful, reinforcing by-product of the pill. We all associate clear skin and glossy hair with good health. When first coming off the pill, everything is going haywire and you might start thinking, 'Oh, I naturally have bad skin and dull hair...bugger that,' but it will pass once it all gets realigned. Meanwhile, I'm seeing first hand the pill's power by seeing what happens when that's taken away.

Even though I'm reading a lot about the ovulation cycle I still don't feel particularly inclined to make a song and dance out of getting my period, or even try practicing fertility awareness. However I get that this cycle effects a whole lot of other bodily functions that I need to be working properly to feel good and think straight - in drawing attention to the effect of the pill, I'm not drawing attention to just the reproductive organs - I'm drawing attention to my brain too - they work together and are not at war, as the Victorians believed. I've heard that the hormone cycle is like the sleep cycle, and that messing with it is just as unhealthy as sleeping just two hours a day or not sleeping for three days at a time regularly, for years. Seeing as both men and women sleep, I like that analogy.

The pill has become a byword for women's liberation, but that liberation is a process that has proven much more complicated, and still ongoing. I don't think we are near achieving what is necessary yet. The association between the pill and liberation has put a lid on the matter, as though after the pill's release, the entire problem was solved. That's not true. I think if we knock the pill off the pedestal we might get further, faster.

Thursday, October 22, 2009

Corsetry

I've been learning a lot from 'It's My Ovaries, Stupid!' - even if the title is so embarrassing I have to fold over the cover to conceal it when I take it out in public. I know I keep saying the birth control pill has a whole body effect but I guess I hadn't even quite gathered the true meaning of that until now. The list I made in an earlier post of all the bodily functions that are linked in to hormone fluctuations, well that made things slightly clearer, but yesterday I gave the rest of the chapters a proper read and the extent of those links, and the problems caused in breaking them are more serious than I'd even considered they could be.

Women's brains and bodies are designed to work within the cyclical pattern created by the monthly rise and fall of hormone levels. The pill creates lower levels of hormones in your body than what should be occurring naturally. So, you're not adding hormones, the action of the chemicals is to suppress the hormone fluctuations and create a continuously lower production. The pill stops the ovaries functioning as they are meant to and this affects all your bodily systems. The ovaries are inextricably involved with the entire endocrine, hormone controlling, system - that's the hypothalamus, the pituitary gland, parathyroid, thyroid, adrenal gland and pancreas. Not only does any change in hormone balances effect this entire system - a system which controls and regulates metabolism, development, internal balances and mood - but every tissue in the body also has receptors, or docking sites for hormones.

Your estrogen levels are lowered when taking the pill - they have to be to stop your body ovulating. Low levels of estrogen, along with the very low levels of testosterone caused by the pill, produces memory loss, sleep disturbances and emotional imbalances. Low levels can also directly produce chronic fatigue, panic attacks and depression. Other problems can manifest in a worsening of allergies, increase in UTIs and irritable bowel issues as the changed hormone level impacts on your immune system. Your body is not working at its optimal rate, and if it doesn't get to reach this rate for years and years then the body is basically under constant stress.

This book does not outright condemn birth control pills - as I said before, it is more menopause focused, but when discussing the onset of what is called 'premature ovarian decline' one of the possible initiators is marked as long-term use of the pill. Dr Vliet talks frequently about 'endocrine disruptors' and does admit pills with high progestogen content are disruptive, but as far as I can understand, all birth control pills disrupt this system, they have to to shut down ovulation. Every woman's body is different, and their hormone levels and the changes are different, but it makes complete sense scientifically that the pill would impact on the immune system etc and if this impact is kept up over a decade it might not be so healthy. I don't think that's scaremongering, that's just common sense. Endocrine disruptors are described as duplicating normal hormones, blocking hormone function, interrupting signal systems and killing sex hormones, so that's the pill right?

Dr Vliet argues that women should be having their hormone levels checked by GPs rather than just being prescribed anti-depressants or being told to take hot baths and drink some wine and all that. She is very clear that ovaries are more than the 'egg factory' we have been persuaded to see them as. But, one thing she is adamant about is that we are not at the mercy of our hormones. The physiological is being confused with the psychological, the two are connected, but rather than women who are tired and down being given other pills, it would be more productive if it was considered that their hormone levels might be out of whack. Hormones effect how we respond to the external world, and how we respond effects our hormones.

Mood and anxiety problems can be traced back to a decline in estrogen and progesterone, matched with a higher level of progesterone (the pill gives a constant supply of progesterone, when naturally we only produce it after ovulation until our period); a deficiency in vitamins and minerals and metabolism - particularly abnormal glucose regulation and changes in sodium and potassium levels. If you look back to that list of bodily functions effected by hormonal fluctuations you will see I'm repeating here. The pill flattens out hormone fluctuations into one long, low line of constant estrogen and progesterone at constant low levels. Fluctuations trigger and provoke vital functions in the body, so if there are no fluctuations, these systems aren't working at the normal rate needed for optimum whole body health.

Of course there are women out there who don't experience anxiety or depression from the pill. That might be because the flattening out of their hormone levels, which may be naturally particularly extreme in fluctuations, appears to help their mood. Also, some women might not experiences any issues until one, five or ten years into using the pill. I think understanding that the pill impacts on all our bodily functions makes the reasons behind this clearer. Of course, some women will have been on the pill so long they won't know what it's like for their body or their moods to be any other way. And some women may start and stop the pill depending on whether they are seeing someone or not and so the build-up effect will be changed. What's important to get is that every body has a delicate system, and each person's is slightly different - the pill does not account for this, and as such is a rather crude, sledge hammer-like way of preventing pregnancy.

I've been reading Susan Faludi's 'Backlash' at the same time. I like reading the pill into all the places it is so absent. I guess it's something like re-reading books under 'queer theory' or 'post-colonial studies' - or like when you see patterns in the spaces between sentences on a page, and once you see them you can't stop seeing them. Talking about the representation of women in mass media and marketing, she says: "The 'feminine' woman is forever static and childlike...we see her silenced, infantalised, frozen."

The pill shuts down the big part of what makes women female, it stops the natural ever-moving ever-changing peaks and troughs of the cycle which is fundamental to the life of the body and the mind. On the pill you are essentially 'static' - it's a long, flat line of day-in-day-out sameness in there. Often it's just as we change from a child to an adult that we close it all down. If you only feel that nothingness, that who-cares feeling, your body is being pushed down and boxed in and that gets pretty frustrating after a while. Women believe they're neurotic, we've come to accept the promoted idea that we are overreactors, over-emotional, high strung. We kind of don't trust ourselves to react right to anything, and however we react we reel it back in under control with a bunch of pop psychology. It's perfectly normal to be sad or angry, but it's much better to feel anything if you know it's you and your situation that's making those feelings and not the chemicals you are putting into your body messing around with it. That makes you doubt yourself - your judgement, your insight and instincts - even more so until you feel entirely powerless. Which in turn stops us talking to each other and saying, "hang on, maybe..."

"It is important not only that she wear rib-crushing garments but that she lace them up herself."

Tuesday, October 20, 2009

Pill enforced abstinence

'Condom rivals pill's popularity' says the BBC today. This research comes from the Office For National Statistics, so I guess we can trust them. A quarter of the 1,093 women surveyed said they use condoms over other methods for contraception. The same number were taking the birth control pill. Half on the women using condoms cited worries about STIs as their main motive. The report also mentioned that only 40% of women were aware of the emergency intrauterine device.

I have to say, I wasn't sure what they meant by this and had to look it up. I know what an IUD is, but hadn't realised that the copper kind is effective in preventing pregnancy if inserted up to five days after unprotected sex.

A representative from the Family Planning Association usefully stated, "There are fifteen methods of contraception available. Women should be able to access all of them in equal measure." Fifteen? I'll come back to that in a minute.

I also read the report on this study on the Jezebel website and the posted comments were interesting. A fair few women talked about how they used both condoms and the pill, because of their distrust of the pill's effectiveness or because of STIs. The board discussion ended up on the topic of what they called 'pill enforced abstinence' - how the pill is a very successful method for them as it stops them even think about wanting to have sex.

The number of people contracting STIs like chlamydia and gonorrhea has risen dramatically in recent years, significantly so in the US under the Bush administration. Abstinence-only sex education also increased the numbers of unwanted pregnancies. The Guardian reported a couple of months back that the number of young men with HIV doubled during Bush's time as president.

When you're in a long term relationship, or married, you get mired in thinking about all relationships a certain way. Early on in a relationship, or in a casual relationship, you'd think everyone would want to use condoms, so the numbers in this study seem a little low considering the ratio of people in long term versus casual relationships. It's worth noting women are far more likely to contract infections than men. Somewhere around $15 billion dollars is spent annually, apparently, by the US health care system on taking care of people with STIs. Those pharmaceutical companies manufacturing the pill really must have a good lot of power to keep pushing so hard. I wonder how many women do use both the pill and condoms. I had always thought I was extraordinarily anxious.

I was discussing condoms with a friend the other day, trying to figure out the aversion to them - I'd recently received a couple of messages reiterating this hatred of condoms I've talked about before. We wondered if the dislike lay in part in the fact that using a condom necessitates stopping the lead up to sex and in that moment of stopping you have a minute when you might start thinking about stuff you don't want to be thinking about. Like the potential baby making consequences of what you're about to do. But maybe also whether you really want to do what you're about to do with the person you're about to do it with, how you feel about them, and they you and what you are doing together. As my friend said, it kind of makes you consider the partnership element of even the most casual situation.

I have been considering experimenting on myself with contraceptive alternatives to the pill. I thought I might try out a diaphragm and report back on how difficult it was to acquire, what it was like to get fitted by a doctor and using it and so on. I've been looking into how much an examination might cost: between $50 and $200 here in the US and the diaphragm itself: $15 to $75. Not sure I have deprogrammed myself enough at this point out of thinking anything other than the pill is unreliable.

Today, I came across two types of diaphragm that have been in the making for a long while, and looking for approval from the FDA this year. One is called Duet which is one-size-fits-all and disposable. The other is called the SILCs diaphragm which also wouldn't require a fitting and has a more easily usable shape. The Duet will contain a new kind of spermicide called BufferGel which doesn't contain detergents and so is less likely to cause the infections women can get with normal spermicides. It also will protect women from a number of STDs, possibly even HIV.

Both these diaphragms have been developed by non-profit organisations relying on donations or grants. I was intrigued to see that the pharmaceutical company Schering was involved in the development of the SILCs version initially, but pulled out two years ago after their merge with Bayer. SILCs creation appears to be more focused on the requirements of women in developing countries with little access to doctors, whereas Duet's makers appear to be concentrating on its ability to protect against pregnancy and STIs.

Here are the sites. I was interested just to see what they look like. It's not often you actually get to see a diaphragm, you have to go looking.

http://www.reprotect.com/products.shtml

http://www.silcs.com/html/ovrview.html

Fifteen methods of contraception are out there and despite all my research I could only figure out eight of them. I had a look on the Planned Parenthood site. They include abstinence, withdrawal and what they call 'outercourse' in their list of methods. You can even read about the benefits and disadvantages of outercourse. Aside from all the hormone-based kinds (the pill, the implant, the injection, the ring) there are three non-hormone based kinds other than the diaphragm and IUD that don't require subverting your humanity - the sponge, the cervical cap and the female condom.

None of these are ineffective or even that difficult to use, so it's interesting that my immediate reaction is to think of them like 'comedy' contraceptives. I instantly equate these methods, which are perfectly safe, with the myths of crisps, Coca Cola and chicken skin I wrote about in my last post. On first response they seem silly and archaic to me and I am able to justify their marginalisation. I can think that way even though I don't believe the pill to be modern, sensible or innovative. When confronted with other options, I'm still elevating the pill in my mind, even though I no longer take it because I know it should not be elevated. Hmmm. That Femodette packet is still waiting for me to give in and jump back on the wagon.

Sunday, October 18, 2009

Pill pushers

I got Google alerted to a post made by Derren Brown about contraceptive myths on his blog. Bayer Schering Pharma (the company behind the birth control pill Yasmin or Yaz) funded a survey of a 1000 women and one in five of them apparently said they, or people they knew, had used items such a chicken skin, cling film or bread to prevent pregnancy. Other women told the researchers they'd heard Coca Cola, kebabs and crisps could also be effective contraceptives.

This must have delighted Bayer Schering who I'm sure promptly circulated their findings, drumming up support for their credible contraceptive pills. However, someone commented on this post that she had recently conducted her own survey, the results of which showed that most women are pushed to take the pill by their doctors and not offered any alternatives. "I'm not surprised we have a high rate of unwanted pregnancy in the UK if people are thinking it's the pill or nothing," she argued.

The power of pharmaceutical companies and their profit motive has driven alternative contraceptive methods out. Not only are doctors not educated about non-hormonal IUDs, diaphragms, female condoms, spermicides, but the suppression of discussion of these alternatives through marketing campaigns and the grants and funds wielded by the companies has made all other contraceptive methods appear suspicious and untrustworthy. The assumption is made that if a method isn't talked about, and few women use it, that it must be less reliable or less safe than the pill.

The pill makes these companies a lot of money, Yasmin and Yaz makes Bayer Schering more money than any of the other medications it produces. The level of ignorance they were purporting as standard through the survey is immensely useful. If women don't know how to prevent pregnancy, then it's much easier to sell the pill.

Margaret Sanger fought for education, availability, and freedom of choice. She wanted women to know how to prevent pregnancy and to be able to choose, and then be given, the method of contraception they wanted to use. The dominance of the birth control pill in the education of both doctors and women and the resulting lack of discussion and availability of other forms of contraception is in opposition to Margaret Sanger's original motivation. Many women are not getting to choose their contraception, they are being pushed towards one method. A method that might well not suit them, and one which is far from perfect, let alone the most effective.

In criticising the pill, I'm not undermining Margaret Sanger's work, but asking for a reconsideration of how far we've moved away from her ideals.

Back to that comment on Derren Brown's blog - if women believe that their choice for contraception is the pill or nothing and if the pill makes them feel lousy, or causes them health problems then they may well stop taking it. If they have no knowledge of, or trust in, other methods then they are more likely to have an unwanted pregnancy. I have heard doctors often argue that research that reflects negatively on the pill should not be released because it may scare women into stopping taking it. This seems a very messed up moralism.

I've been reading Susan Faludi's book 'Backlash' - she dedicates a chapter to the anti-abortion movement that first became powerful in the US under the Reagan administrations of the 1980s. The lobbyists and campaigners involved in this movement did not limit their aggressive techniques to abortion, as a result of their work they also made a massive impact on birth control. The anti-abortion movement inspired massive cutbacks in public and private support and funding for birth control clinics and family planning services. Federal and state aid fell by by $50 million dollars between 1980 and 87. The campaign also persuaded many charities, corporations and foundations to withdraw their donations.

Research into birth control was halted. Government funding was withdrawn, alongside that of corporations and individuals. By the end of the 1980s only one busines was still funding research. Insurance companies stopped covering clinical trials. A 1990 Institute of Medicine study discovered that in that decade the US had fallen heavily from its position as world leader in contraceptive development.

Cuts in funding does not only mean less research being conducted into possible new methods of contraception (much of the research being undertaken was likely concentrated on the pill anyway) - but also research into the side effects of the birth control pill. If there was some concentration on other methods that would have surely been shut down for all available money to be funnelled into pill research - from which the companies could make the most profit. Most of the research into alternatives does seem to have gone predominantly into hormonal-based methods - the injection, patch, ring and implant.

It makes you wonder if there might be a method of contraception that could be taken orally, that could have all the easiness of the pill, but would not need to be taken every day in order to shut down the ovulation cycle. Perhaps there's something out there only found in one type of plant growing in one area of the world that would not have an insiduous whole body effect. If there is it will never be found whilst the pill is still popular.

Emily Otto wrote to me about her experience with her doctor and the pill, and what she said I think is worth including here:

"My doctor put me on Yaz when I went to her regarding my complexion and asked for a referral to a dermatologist. I persisted that I didn’t want to take hormones but she rattled off a list of amazing things it does for you (shorter periods, clear skin etc). So I tried it. After three days of being on the pill I started with daily migraines. I had suffered migraines before but only 2 or 3 times a year.

I went back to my doctor and she insisted it wasn’t the pill but if I was unhappy she could give me the Depo-Provera shot. With the shot I wouldn’t have to worry about taking a pill every day….that was her logic. I of course refused. She told me that I had fluid in my ears and that the migraines were probably due to allergies but to be on the safe side she wanted to refer me to an ENT. I went to the ENT who did a ton of exams: MRI, auditory brainstem response test, and others. He also assured me that the pill did not cause the migraines. The migraines got so intense and the vertigo was so bad that one day I fell out of my chair at work and my boss insisted I go to the ER. The ER docs also assured me that the pill did not cause the migraines and they referred me to a neurologist.

At this point I stopped taking the pill and after a month of being off it the migraines ended. None of the tests came back abnormal. But since going off of Yaz I am unable to drink caffeine, it is an instant trigger for migraines. I have since gotten a new doctor and a GYN and they both agree that Yaz caused the migraines and I am fortunate not to have had a stroke. Regarding my new sensitivity to caffeine, my doctor said that the pill changed the blood flow in my brain. My original concern about my skin turned out to be rosacea, it has nothing to do with acne which was the reason why my original doctor first put me on the pill. The pill pushing mentality of my doctor to address a concern completely unrelated to fertility is appalling. I should have known better than to take the wonder drug."

After writing my previous blog I've been wondering whether there's a backlash against the pill brewing - with the Yasmin lawsuits, the release of 'The Pill: Are You Sure It's For You?', tests into a male contraceptive and recent new stories. Considering history, I have a funny feeling any kind of backlash might not be wholly supportive of women. Women are apparently doing better in the recession, partly because men aren't doing as well and so maybe, just maybe they need to be brought down a peg or two.

It might be argued that women choose to take the pill and so women, and not the pill, are responsible for the problems it has caused. These 'problems' will likely focus on the enhancement of the human race - stuff like that story about the pill making women attracted to feminine-looking men - and possibly the environment - the chemicals from the pill flushing into the drinking water, the sea. If women choose to come off the pill and, due on lack of knowledge, get pregnant, then they'll be seen to be adding to the overpopulation problem. If they decide to get an abortion, well...

At the start of Susan Faludi's book she considers the building drama, suggesting women should be ready to be confronted with the argument that "they gained control over their fertility only to destroy it."

I really hope it swings our way this time.

Friday, October 16, 2009

Selling sexiness back

In my last post I mentioned I'd read the book 'For Her Own Good' and - after a Facebook-based debate about the views expressed by women about women in The Daily Mail -I feel the need to explain how this book has helped me figure out further why the birth control pill is so rarely and reluctantly criticised. Bare with me, and I'll try to condense all the thoughts down so I don't loop out theorising forever.

The writers Barbara Ehrenreich and Deirdre English begin with Charlotte Perkins Gilman, the 19th century author of 'The Yellow Wallpaper' - a partly autobiographical short story about a woman who, feeling unwell, is prescribed the 'rest cure' by her doctor. In that era there was something of an epidemic of sickness amongst middle class women. These women had servants and maids, only a few acceptable ways of entertaining themselves and were entirely dependent on their husbands. What Gilman called the 'sexuo-economic' relationship between husbands and wives made women, as she saw it, little more than well-kept prostitutes.

With no work to do, and no allowance for thinking, reading or learning, concentration was on their bodies. Women fell ill and took to their beds in response to this situation. The fainting, weak, child-like woman was seen as very attractive at the time - think of it like the 'heroin chic' of the mid 1800s. Being sickly was so much the fashion women would drink vinegar and arsenic to bring on symptoms.

The uterus was considered the controlling organ, the rest of women's bodies centred around it. The focus on this was not however connected to an understanding of women's sexuality - that idea was a threat to their main reproductive role. Doctors believed the uterus competed with the brain, that there was no possibility of them working harmoniously together. This discord showed that women were intrinsically, inately sick as a result of their very womanliness. Femininity was a mental illness. The sickness of the middle class 19th century woman was always directly linked to her reproductive organs.

But the doctors realised that if women were truly sick all the time, then they wouldn't be so good at having babies. They feared all these women taken to their beds would cause a fall in the birth rate. Likely part of women's enthusiasm for sickness was that it got them out of having more children. This is when the idea of hysteria was introduced, which I've spoken of before. If a woman was hysterical then she wasn't really ill and could have babies. Simple. The writers suggest that hysteria was also used by women to express their anger over such manipulation.

Children became the focus of medicine. Society put all its hopes for progress into the idea of the child. Motherhood and the raising of children was elevated to a high level of importance. But far from giving women a better foothold and more control, doctors insisted women were not to be trusted with such a vital role. The child held a much better status than the mother. To enable their own involvement in the child rearing process, doctors decreed that pregnancy brought out in women the 'horror of being female.' Women would try and satisfy their own needs over the baby's and thus cause psychological damage.

Fast forward to the 1950s and the growing consumer economy gave a certain power to women. They were the ones buying all the stuff for the house and therefore the market became very attentive towards their wants and needs, at least in terms of appliances. Men, however, blamed the changing economy for making them feel unmanly. Success now would come from selfishness, ruthlessness and individualism. Women were still in the home, looking after their families rather unselfishly. This presented a problem, a problem solved when the medical authories branded maternal self-sacrifice as masochism. In this culture of self-gratification women's mentality, their self-denial, was a disease. Women were masochists, and as such liked the menial labour of housework and a good dose of sexual humiliation.

The discovery of hormones in the 1920s gave doctors the necessary 'evidence' to continue to twist the use of psychology in female biology. Menstrual problems and infertility were caused by 'incomplete feminisation.' If women were unhappy with their housewife and mothering duties it was because they were rejecting their femininity, and as such not well in the head. Pregnancy was the most obvious sign to women that they were indeed female, and so women manifested illnesses so as to not get pregnant.

Of course, women were rejecting their feminity - or the idea of feminity that they had been presented with for so long. They didn't want to be restricted to the marriage, housewife, children cycle. They did want to work, have careers. But, very interestingly to me, this movement was entirely supported by the needs of the economy. Men and women were being encouraged to buy more and more stuff, particularly after the introduction of a TV into every home, and they couldn't buy it all and have holidays on the man's salary alone. So women had to go out to work to pay for this aspirational living.

The number of single women grew as a result - they could work and support themselves without men. In 1962 'Sex And The Single Girl' by Helen Gutley Brown was released. Clearly, this was a good move, women could be independent. But, yet again, this was fully encouraged by the market - more single people means more demand for stuff. Rather than sharing the stuff, they each needed their own. 'For Her Own Good' contains a brilliant quote from the director of market research for a major company taken from a 1974 interview:

"There's nothing in this that business would be opposed to. People living alone need the same things as people living in families. The difference is there's no sharing. So really this trend is good as it means you sell more products. The only trend in living arrangements that business does not look favourably on is this thing with communes, because here you have a number of people using the same products."

He also explained in the interview that business dealt with the threat of communal living by keeping the idea out of the media. Instead the glamour of singleness was, and is still, promoted. Singleness opened up whole new markets for selling - travel, liquor, leisure, clothes, cosmetics...Single women would spend, not save. This ethos of individualism and self-gratification infiltrated relations between men and women. If you are only responsible for yourself then a relationship should only be continued as long as it is 'emotionally profitable.' Your needs are legitimate and important but people are entirely replaceable.

Single and married women went to work and were pushed to imitate men, but remain attractive. They had to deny that they had any different needs in order to succeed - such as allowances for pregnancy, child care, that they would leave work only to start their second job as housewife and mother. Children presented a conundrum to the early consumer economy - they were a spanner in the works. So, it was necessary for it to be understood that women choose to have a child, and if they can choose to or not to, then there's no neccessity for supporting a working woman who does fall pregnant.

Let's back up - the pill was released in 1960 - allowing women to choose more easily whether to have a baby or not and when. It stopped all the talk about women being fit for work alongside men, and all the talk about the battle between women's heads and reproductive organs. The pill shut those damn reproductive organs up. Now they were out of the debate, life was meant to be much easier. Faced with the constant speculation of doctors worrying over their uteruses and ovaries, it's understandable women happily took a pill that could silence the issue. Even if it meant the medical authorities kept their control. 'For Her Own Good' doesn't talk about all this. I'm just wondering now.

Also, if you could be single, but knew you couldn't be single and pregnant and keep working in a world that had only just let you in and you'd have to get the man to marry you, then the pill must have been very attractive. As I said before, I guess feminists retrospectively see the pill as a catalyst in the change of situation for women. When in a way, the pill was helping women fit into a still male-dominated society, and keeping everyone happy - except her, once the high estrogen content kicked in with depression. By taking the pill, women were choosing as the economy wanted, and that meant the workplace didn't have to give support were a woman to be pregnant. Similarly a single, or married man didn't have to support the woman who got pregnant by him.

Enrenreich and English go on to argue that sex during this time was fully separated from reproduction - as it was, with the pill, although they bizarrely don't say this. Once sex and reproduction were no longer connected, it was easier to detach sex from commitment or affection, even. Sex could then be commodified, and sold back to people in the form of 'sexy' cars, clothes and so on. The introduction of the pill allowed the market to develop its main selling technique, the method that is utilised to great effect to this day.

Ariel Levy's 'Female Chauvanist Pigs' makes this point well - again, though, without not one mention of the pill in the entire book (sorry I just can't believe it):

"Making sexiness something quantifiable makes it easier to explain and to market. If you remove the human factor from sex and make it about stuff then you can sell it. Suddenly sex requires shopping."

In the same book, Candida Royalle is quoted as saying:

"Revolutionary movements tend to be co-opted - swallowed up by the mainstream and turned into pop culture. The real power is pretty much dissipated."

Feminists hedged their bets at this stage, and now looking back, with the individual choice emphasised by the economy, by those looking to make more and more money. The pill represents choice. Individual choice led to individual rights, rather than social change. The movement is entirely defensive of this stance. The goodness and rightness of choice has been promoted for its own sake, despite the choices presented not being formed or created by women. Women had choices, but they didn't select what they could choose from. Ehrenreich and English believe as women were accepted into a man's world, they were also marginalised, and along with them 'human values' were pushed out to make way for socially supported selfishness and individualism.

What I took from this book was that the birth control pill is kind of intrinsically connected to the development of society, and as the values and morals of the consumer economy are still very much with us today, the pill still holds the same position of power. All that was believed then, is still believed now, but far more strongly. The ideas - the profitability of relationships, the drive for self fulfillment - have really settled in and solidified, as has the pill. People no more question the pill than they will question why they want to another handbag or sex toy.

Then if you think how the pill effects women's bodies, their emotions and responses to the world, you can see how it could actively help separate men from women in the 'war of the sexes.' Plus, the sex sells method of advertising aside, if women don't feel sexual, let alone sexy, in a world obsessed, because of the pill's impact on their hormone levels then they are more likely to want to buy stuff that will help them feel that way - toys, clothes, brazilian bikini waxes. And perhaps the more detached we are from our bodies the more we are happy to put it through in order to feel sexy - breast implants, liposuction, collagen injections. That detachment might also drive us to act like our bodies don't even belong to us and take pole dancing classes for exercise, become strippers to pay for college, make amateur porn for youporn.com or star in a Girls Gone Wild video.

I'm just speculating here.

Thursday, October 15, 2009

That cannon

Just a little over a month ago now I said I'd stopped taking the pill, for good, after nearly a decade of popping one brand or another. It's been a strange few weeks. Within days of stopping I stepped right into a condom accident freak out. It was barely an accident and most unlikely to have resulted in getting me pregnant, so hardly warranting the stress it caused. I had a miserable day of trying to convince myself I was being unreasonable before giving in and getting the emergency contraceptive pill.

Once I'd taken that, because it wasn't right away I managed to conjure up a fair few pregnancy symptoms in the next week. I notched up nausea, tasting metal in the morning, what I thought was 'implantation' bleeding, cramps and what I can only describe as an over-awareness of my breasts. By the time my period came I was wondering which country I'd want to bring my child up in (Japan or France it seemed).

Even though I'd sworn of the pill under the belief that the build up effect of years of chemicals coursing around my body was clearly making its full impact, I soon popped another pill to try and make my post-pill anxiety, as much as my potential baby, go away. I might be sat here tapping out all these rational, reasoned thoughts but I'm still now struggling with not taking the pill. I guess that helps me to see how important it is to discuss the pill openly, and disagree with that diplomatic immunity it has gained over the years. One moment I'm asking, why are women still taking the pill? And the next I'm eyeing up that Femodette packet waiting in my wash bag.

Some of the changes I was taking to be signals of my pregnancy were likely more to do with my hormone levels figuring back to normal. It felt a bit like a stalled, cold car slowly rumbling to life. Not a romantic image I know. The morning after pill definitely hindered that progress and threw me off balence. In the last few days though I have started to feel different in the way I did a few months back when I experimented with stopping the pill before retreating back again. Stuff tastes better, and feels better - my sense of touch is more sensitive. I don't feel mind achingly tired by 8pm every day. I'm really enjoying just thinking, sitting and thinking thoughts and that leading to other thoughts and on and on. I feel more, not confident, but able to cope - if I feel sad or angry it doesn't overwhelm me, I see my way out of it. Rather than waking up with the feeling that something horrible has happened and I just have to wait until I remember what, I don't feel fearful at all, I feel grounded. I'm intrigued to see where this goes now. I won't be going back this time.

I putting myself through something of a condensed course in women's studies. I've had one of those ding-ding-ding moments with this book Barbara Ehrenreich wrote in the 1970s, 'For Her Own Good.' It explains the history of women through the progress of medicine and psychology. It's brilliant, but mentions the pill just once even though its invention and use completely supports the arguments that are made.

But I'll come back to that, because at the library today I picked up a cheesy looking book called 'It's My Ovaries Stupid!' written by Dr Elizabeth Lee Vleit. It was on the menopause shelf. That this book hardly mentions the pill is actually very useful. Dr Vleit outlines how our ovaries, and the hormones involved in the ovulation cycle, work and what effect they have in the body. So rather than thinking about the cycle from the point of view of how it's effected by taking the pill, I could read how the cycle is meant to function normally.

Many women think, and are told by their GPs, that the pill 'regulates' their natural cycle. This is wrong - the pill stops your natural cycle completely and replaces it with a continuous dose of chemicals created to represent oestrogen and progesterone. The periods you have are not periods at all, but a symptom of withdrawal. That bears repeating. In the 1800s doctors advised that women who were troublesome, argumentative, overtly sexual or too hungry should have an ovariotomy. That's a complete removal of the ovaries. Doctors recorded that women who underwent this surgery were often cured, becoming 'orderly, industrious, cleanly.' The action of the pill can be likened to a modern version of this procedure. Rather than female castration as the ovariotomy was also called, the pill is a chemical castration. The ovaries are shut down, rather than removed.

In 'It's My Ovaries Stupid!' there is a list of changes that occur in the body in direct relation to the hormonal fluctuations of the menstrual cycle:

Body temperature
Blood glucose regulation
Energy levels and sleep patterns
Thyroid and adrenal hormone production
Skin colour, texture
Memory and concentration
Brain wave patterns
Balance, fine motor coordination
Metabolism rate
Levels of adrenalin
Visual, auditory and olfactory acuity
Pain threshold
Concentrations of vitamins

Hormonal fluctuations are flattened out by taking the pill. During a normal cycle the level of estrogen will rise in the first half of the month leading to ovulation, when it will peak, and then levels will drop. Progesterone levels will rise after ovulation and peak in the last week of the cycle. These are significant, dramatic fluctuations. When you take the pill this all stops and is masked with a continuous level of synthetic versions of these hormones with no peaks, and no falls. It is the fluctuations that initiate and regulate all of the above functions, and more. The effect of the pill is not just 'stopping you producing eggs' as that nice doctor once told me.

Reading how hormones work on nearly every organ and tissue in your body makes taking the pill seem like a very crude, aggressive method of contraception. The emotional side effects many women experience from the pill - the tiredness, tearfulness, anxiety attacks, brain fog - and the physical side effects - worsening allergies, migraines, aching joints, hair loss, bladder infections - are the result of the body being thrown completely off balance.

Monday, October 12, 2009

Down and out

Do you want to take the pill?

I've asked this of a few women lately, their immediate answers revolved not around what they actively wanted, but what they actively did not want. They did not want to get pregnant, they did not want to worry about getting pregnant, they did not want to take the pill but...They were thrown by the question, as I still am now thinking about it.

My, and their response, comes from a feeling of not having a choice, of the matter of wanting to do this or not being unimportant. We think: taking the pill is sensible, responsible, irrefutable in its rationality - this is the most effective contraception method, I can take it and stop worrying about an unwanted pregnancy. Of course, I've suggested here that these assertions are far from irrefutable.

I've spoken to a fair few women who feel they are, or were, addicted to taking the pill. Their need to take it is pervasive enough to be rootless. We keep taking it even when we know it is making us unwell, because there's some higher purpose here, some matter we must be martyred to. Not getting pregnant, perhaps. But also, I think, control over our bodies - and getting pregnant would be the ultimate in losing that control.

Emily Martin's 'The Woman In The Body' has been helping me make sense of why the women's movement so enthusiastically backed the pill on its release, and still does for the most part. As I said before, women's studies books, women's issues sections of newspapers, women's magazines usually only speak about the pill as a glorious invention, untouchable in its intrinsic goodness. If criticisms are raised they are always tempered with this same sentiment. This, I am certain, has to do, in part, with the concern that women will be stop taking the pill and this will cause a huge increase in unwanted pregnancies. I doubt the truth behind such reasoning but surely if this shows anything it would be a lack of understanding amongst women about their bodies and how contraceptives work.

Before the release of the pill women were stuck in a world in which it was believed that women were unable to function outside of the home due on the feminine functions of their bodies. Their menstrual cycles were seen as weakening, causing irrational behaviour and debilitating them for a week of every month. That's simplifying, but basically those campaigning for a change in attitudes towards women needed to play down the role of the menstrual cycle in women's lives. They had to quash the thought that women were effected by their bodies, their hormones if they were to fight for equal footing in the workplace.

Considering this, it is understandable that the pill was joyously welcomed. What better way of escaping this trap than giving women a pill that would shut down the menstrual cycle and control hormones?

Emily Martin argues that society's view of women and menstruation was driven by the developing capitalist economy. People, men and women, were being seen in terms of productivity, and there was a need to make people as productive as possible in the workplace. Women were seen as less productive than men. Martin suggests that in playing down the impact of menstrual cycle the women's movement was effectively maneouvering to get women out of their homes and into factories, offices.

The pill, of course, put a stop to this playing down entirely, and enabled women to take on not just work, but careers. The pill made women more productive within a capitalist system. Martin takes the stance that it was never women that needed fixing to fit the system, but the system itself that should change. Although, she doesn't, as I keep saying, consider or discuss the role of the pill herself - I'm just filtering this in.

Now it's like we feel we can't admit our cycles and hormones are important to our well being. If we do we worry we'll get pushed back into that box.

When I asked women whether they wanted to take the pill what also came up was this sense of fear of their own bodies, a feeling that their body might betray them with a pregnancy if it wasn't kept under strict control. The problem here is, we are not constantly brimming over with fertility and in fact we are only definitely fertile a certain number of days a month - hence why we hear about couples trying for a baby working out when these days might be.

That said, there is the possibility of getting pregnant on days around that fertile time, especially if you don't have regular 28 day cycles. So, I'm no advocate of the rhythm method. I know most women would find it intolerably stressful. But I do think the pill's addictive quality is driven by this deep fear.

Yet, it is a chicken and egg conundrum because the earlier you start taking the pill, the longer you take it for, the less and less you understand about the workings of your female body. The less you understand, the more fearful you become. You are not feeling the natural monthly changes, there is no connection between your physicality, your mind and your emotions and so your body becomes disassociated from your sense of self.

Women often talk about periods, and births, as though they are things that happen to them, rather than things they themselves actually actively do. It can be the same with the pill, we feel it is something that is put upon us, rather than something we actively chose to take.

Simon De Beauvoir in 'The Second Sex' discusses women's feelings towards their bodies - 'Because her body is suspect to her, and because she views it with alarm, it seems to her to be sick, it is sick.'

What do we do when we feel sick? We take a pill.

Friday, October 9, 2009

For men

Could the birth control pill be the secret behind Zack Efron's success? I'm away for just a few days and another big pill story hits the news, and one that despite its slant fits in particularly well with my theorising. The Daily Mail published a piece with the headline 'Taking the pill for the past forty years has put women off masculine men.' The Daily Mail bizarrely seems to be leading the way in changing attitudes towards the pill. I'm not sure of its 'agenda' - I'd guess it's more conservative than my own -but this is a dramatic story. It takes a holistic approach to the pill's history, the reach of its popularity and the potential impact. It's putting the pill into context.

I've been getting a real kick lately out of reading culturally analytical books with a feminist slant and considering how factoring in the birth control pill could change their conclusions. I've noticed hardly any of these fem studies publications even note the pill's existence. In the US alone 80% of women have taken the pill at some point in their lives. I'm beginning to think you really can't discuss the progress or position of women as a whole since 1960 without looking at the possible impact of the pill. Taking the pill to prevent pregnancy has been described as 'using a cannon to shoot a sparrow' - at the risk of repeating myself, this is a powerful drug that is being taken by millions of women every day for years. And yet hardly any books taking on women's issues - even sexuality or body image - have the background presence of the pill in mind. Women are 50% of the world's population, but when the pill is discussed it is usually either taken completely out of context, or only talked of in terms of the initial positive social impact on women's lives.

The Daily Mail piece is pretty much the same old story which is being recycled every so often to show different sides. That is, it states that women's moods and responses change across the menstrual cycle and these changes are wiped out by the pill. Therefore the pill effects the natural changes that have a knock on effect in relationships and reproduction. This story is similar to the stripper story and the smell story discussed previously. Dr Alexandra Alverge suggests that the pill's effect on how women perceive men has 'long term implications for society.' She also says that, 'the Pill has psychological side effects we are only just discovering' Interestingly the Mail article, and most of the articles on this topic, do not emphasise what this could mean for individual women, or even women generally, but are more concerned with the impact of the findings on the evolution of the human race. Barbara Seaman suggested in her late 1960s book, 'The Doctor's Case Against The Pill' that the pill has 'diplomatic immunity' because of it's use in curbing the problems caused by overpopulation. Well, however the papers want to paint this research is fine by me at this point, at least the idea is getting out there.

Meanwhile they're getting ready to medicate the other 50% of the population - the WHO is looking for men to try out a contraceptive injection. It will contain testosterone and progesterone, the combination of which is meant to reduce sperm count. 400 men will be receiving the injections for one year. If this ever actually gets released, and I suspect the side effects along with the social reaction will make it seem very un-marketable, I can't wait to see how it effects attitudes towards the birth control pill. I suspect if something similar is made available to men, there will be an increase in discussion and analysis of hormone based birth control methods that could lead to some real progress.

Saturday, October 3, 2009

Diagnoses

In 1950 the book 'Once A Month: The Premenstrual Syndrome Handbook' by Dr Katharina Dalton was released. In this, she claims, that PMS 'threatens the very foundations of society.' For half of every month, the two weeks before a woman's period, she can not be trusted with anything but the simplest of tasks, not even in taking care of her own children. Her irrational state of mind makes her a danger to her family, her colleagues, and society at large.

Karen Houppert speculates that the assumed 'weakness' of women was played down during World War II when they were needed to take on the jobs left behind by enlisted men; but once those men returned, women needed to hustled quickly back into the kitchen - and so the mental disorder PMS was born. Women's wombs and ovaries had been linked to their emotional states long before, but PMS proved far more pliable than its ancestor, hysteria.

The existence of PMS has never been proven scientifically, yet in 1950 40% of women were believed to suffer from it for half of every year of their life. Presently, the term PMS is thrown about quite casually, with most women claiming to have experienced it at one time or another. There are over 200 symptoms under this banner - irritability, nervousness, anxiety, anger, stress. A whole range of emotions that fluctuate above a baseline of complete calm can be attributed to a PMS episode. It is often described as 'moodiness' - a word I find odd as all it seems to suggest is that the person is experiencing moods, and all people are always experiencing moods - but 'moodiness' is apparently a uniquely feminine problem. And in 1950, according to Dr Dalton, women's moods were costing American society 8% of the total wage bill.

Of course the 1950s saw an explosion in the invention of all kinds of disorders where normal, healthy, human life experience had been before. Diagnosis was helpful in some cases, and certainly brought a slow halt to the terrible treatment of people truly suffering and previously incarcerated in asylums; but this new enthusiasm for psychotherapy also ushered in some more dubious labelling, and lots of emotional problems that patients were told could only be treated with drugs.

It could be argued that PMS was a convenient way of containing the anger of women who had shown themselves to be very capable in men's jobs during the war, and now resented how they were being boxed back in to the role of housewife. I usually have a tendancy to doubt the organisational skills of those in power to orchestrate the kind of conspiracies that sometimes appear so obvious in hindsight. However, the book I read by Bernard Asbell on the history of the pill suggested its invention was an accident, that various scientists across the world just happened to come together in their research over twenty years, which sounded sort of suspicious to me - and so I read Barbara Seaman's 'Exploding The Estrogen Myth' and discovered that Mr Asbell left out a whole chunk of the pill's history - the part in which synthetic hormones were developed in Nazi Germany, and not just synthetic hormones generally, but the synthetic estrogen that is now used in nearly all birth control pill brands.

Bayer Schering, the company behind Yasmin and Yaz, was previously the Schering Corporation and during World War II they worked on creating the synthetic hormone ethinyl estradiol for experimental use on Jewish prisoners in concentration camps. The Nazis were trying to create a sterilization drug and so would feed liquid synthetic estrogen to men and women and monitor the results. The women stopped menstruating, but were not made permanently infertile. Bayer Schering later went on to introduce the birth control to Europe in the early 1960s.

So, sometimes it's healthy to hold some suspicion. PMS medicalised the emotions experienced by women. It's true that women do feel more this, or more that at certain times in a month, but none of these feelings should be considered 'threats' to anything other than that woman's good day. And, it can be seen as positive that these changes, and as such the broad effect of the menstrual cycle, was being acknowledged by doctors. But as Paula Caplan argues, those doctors were effectively saying: "We'll believe what you women tell us about how you're feeling - but you've got to let us call you mentally ill."

The suggestion that PMS effected other people - even if it was only the husbands and children of the woman - also conveniently made menstruation the public's business. And when periods are made a public problem, we get adverts for pills that stop them entirely in men's magazines. There are many women prescribed the pill for PMS symptoms - Yasmin promoted itself as a unique cure for that moodiness in the beginning - and many women advocate the pill for helping them to feel less angry and upset for the last week of the month. The pill was one of the first medications to be distributed widely to healthy people. Now, there are hundreds of medicines taken by the essentially healthy. Anti-depressants are prescribed with casual frequency, particularly in the US, where they are advertised heavily, and often taken for years and years with little regulation by doctors.

As I've been saying, the pill can produce an endlessly flat, nothingness feeling, as well as causing anxiety, nervousness, anger, depression - all the issues discussed previously. It is natural to feel happy or sad and all that's inbetween. But I know from my experience using the pill that the feelings of PMS are more grounded in real circumstances, less violent and more manageable than the feelings that can be brought on by the birth control pill. With PMS, by which I really mean normal fluctuations in mood brought on by hormonal changes, you know it's coming, you understand why, and you know that it will go away. You also know that there are times when you have every right to be angry.

On the pill, the anxiety can build and build, can go on for months. When you are taking the pill you feel detached from your body, which only makes it harder to handle a rush of anxiety or paranoia. I'm not blaming all the ups and downs of my life, or anyone else's, on taking the pill. I think most women who have felt the pill's effects know the difference between legitimate reactions and pill-related problems. When the pill was first launched the high levels of estrogen produced depression, which I think is related to the flatness women experience today, and which was clearly effective in ridding them of the perils of PMS. Now, new progestogens seem to play a large, and different, part in the emotional side effects of the pill.

"Pills are to sell, not to take. If we put horse manure in a capsule we could sell it to 95% of these doctors."
Harry Loynd, former president of Parke-Davis, a subsidery company of Pfizer.