Tuesday, February 14, 2012

Why can't we criticize the Pill?

This week I've written a piece for the Society for Menstrual Cycle Research's blog, re:Cycling, regarding the difficulty of criticizing the Pill at a time when the Republican front runner in the Presidential race is calling for a ban on contraceptives. It's an issue I've long tried to figure out. There were some very interesting comments in response to this post.

'Why Can't We Criticize the Pill?'

Dr Jerilynn Prior of CEMCOR asked, "When will The Pill no longer be a sacred cow for industry, for physicians and for women?"

Jacqui added, "You have to hand it to the pharmaceutical companies: they are that good at what they do. We have been and still are sliced and diced by these guys. They have the entire game stitched up so that they make the rules, they effectively control the so-called independent bodies that are supposed to regulate them, and with only a small percentage of doctors reading independent medical literature – 10% is the statistic in Switzerland – and presumably only reading what the pharmaceuticals send them, it feels like EVERYONE is on Team Pill except the few people like Holly speaking out."

Last week, in the wake of Obama's so-called 'compromise' on religious employers providing free birth control through their insurance policies to employees, the Washington Post asked me whether I thought the fight over access to birth control was distracting us from considering the potential health risks of the Pill and other hormonal contraceptives. Here's the article that came out of that:

'Obama birth control compromise distracts from issue of whether the pill is safe, activists say.'

Of course, I don't think the religious Right is the only obstacle that is stopping us criticizing the Pill - I think the power of the pharmaceutical companies is a far bigger factor, otherwise in the UK and Europe the debate would be more open and honest than here in the US, and it is not.

It's just interesting to me, and disturbing admittedly, how little concern has been shown over Yaz and Yasmin dabacle considering the sheer number of women effected and involved in law suits. That Rick Santorum is out there wanting to do away with all contraception, at this particular time, I think is one reason behind this, but I don't think I could say it would be any different if this information about Yaz had come out last year instead.

As I have written about in this blog - the position of the Pill, I believe, has to do with ingrained historical and social concepts of women and women's bodies, it has to do with misogyny within the medical industry, it has to do with how women see themselves and how they are willing to change themselves, it has to do with support for women using the Pill being built into the structure of our society.

Consider that there is no direct-to-consumer advertising in the UK or Europe, plus for the most part birth control is free through a national healthcare system. The power of the pharmaceutical industry is not as obvious and overt, although it is still present in the companies' relationships with doctors. But they do not receive visits at their surgeries from representatives plugging certain products. The industry's influence has to be more subtle, more undercover. And yet women are prescribed and take the Pill just as enthusiastically in these countries.

There is so much more behind this silence.

I added these thoughts as an addendum to my piece for re:Cycling:

The power of the pharmaceutical industry is a major factor in this issue. Doctors are massively influenced by money, research and advertising by the workings of this industry. Its primary aim is not to save lives or alleviate suffering – but to make money. Saving lives and alleviating suffering are essentially by-products of this drive. The concept of suffering and illness is stretched and manipulated in order to create voids that can be filled with profit-making medications.

The Pill has a huge market – all women that are fertile and want to avoid pregnancy and now these days all women who are fertile and want to avoid acne, moodiness for a few days a month, bloating before their period, periods in entirety….

I frequently consider other pills that have been revealed as dangerous and the reaction there was to them. I compare and contrast, and see that SOME pills are considered critically. But often the machine makes it seem like we have a need that is more pressing than potential side effects.

I recall Seroxat/Paxil – the anti-depressant that can make young people more depressed and suicidal – and there the debate went along the lines of…well how do we know if it’s the drug doing this or if it’s just the person’s natural state? Even when a mildly depressed person suddenly wants to jump off a cliff. And when people complained that when they tried to come off of the drug they had horrible withdrawal symptoms – and people were committing suicide – the answer given by the industry was – well, don’t come off it then! This all seems very similar to the Pill – it makes women depressed, anxious, it makes them have flu-like symptoms, adrenal fatigue – well, how do we know? They’re taking it for much of their fertile lives, so maybe this is just normal changes that would happen anyway. And they have withdrawal symptoms coming off of the Pill? Well, don’t come off then! – until you want a baby and then we as an industry can send you in the direction of infertility drugs, and they’ll sort you out.

Just like with drugs for psychological disorders there are some people who really, truly benefit from taking them – it totally stops them suffering and turns their lives around – but for a big middle section of people (those with mild depression, grieving, issues that need to be helped through therapy – or for the Pill say, those with slightly heavy periods, some pain, those who just have light, regular periods) drugs that you take every day are not the answer – but they ARE the answer for an industry looking to increase its market. I understand, for example, that some people with, say, ‘attention deficit disorder’ really benefit from a drug (I assume they do) – but there are tons of adults, and children, who have mild concentration issues, are not being attended to at school properly, are doing a job that doesn’t satisfy them, who are going through a difficult phase, for which drugs are not the right choice. The industry’s aim is to open up markets, open up markets and find new customers.

Yet I see a lot more critical thinking out there in regards to psychiatric medications than in discussion of hormonal contraceptives. So there’s more at play here. The threat of the Religious right, yes. But more than that. As I write about in my blog – acceptance of the Pill, enthusiasm for the Pill, I believe comes from ingrained historical and social concepts of women and women’s bodies, and from the resulting willingness of women to change and behave in certain ways in response to these concepts.

In response, Heather D. summed it up with - "There are larger gender issues involved here... (we can) link this to larger issues of women being accustomed to molding themselves for others’ gazes and purposes. Therefore this is about large-scale ideological forces as well as large-scale economic and political forces."

Those that are criticizing the Pill are immediately tagged as having a religious agenda. They are dismissed because the religious Right is the only group of people that are given a voice and a platform - or that takes that platform by force. Those, like me, who have very reasoned concerns about hormonal contraceptives are lumped in with the group that takes up the most column inches in the papers. In a sense, it's an easy and simple explanation for any criticism used by those who have not done much thinking about the Pill. It works to elevate the Pill's position even higher, and to undermine even the most scientific and least religious arguments. Putting us all in the category of 'crazy' allows everyone to stop thinking about what we're actually saying.

It's an odd experience to watch Jon Stewart, say, or Bill Maher or Rachel Maddow take the populist stance in protection and praise of hormonal contraceptives. I don't expect to know better than them.

There are plenty of women coming off the Pill, and plenty of women who have vowed to never use it again, and many who try to talk to their friends about the potential health issues but we, as a group, can't find our footing and get organized when we feel the need to be guarded against accusations of Catholicism and misogyny. It's a fight for sure, but it's a fight worth having.


  1. Thank you for taking the time and effort to fight. I know several women who have suffered serious consequences from taking birth control.

    Your viewpoint makes a lot of sense, but as a man I am told that I am unqualified to agree with you.

    It is often fun to quote the opinions of Ghandi or Freud on birth control and have people tell me to "keep your Catholic Anti-Choice views to yourself". Contraceptives were fairly universally rejected until the last 50-60 years. It's not a Christian thing, or a Catholic thing. It used to be a Common Sense thing.

  2. Hi Holly,

    A friend shared your article (as posted on menstruationresearch.org) on my Facebook wall just this afternoon, both because it is excellent and because she noticed that you linked to my recent opinion piece on CNN in the comments. When I saw the name of your blog, I recognized it from your comment on the CNN article, and it reminded me that I wanted to follow up with you. If you are still interested in getting in touch with me, you can contact me at vpokorny@me.com. In the meantime, I look forward to reading more of your blog! Thank you for your work! ~ Valerie