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.

Thursday, February 9, 2012

Hysteric

'Just how safe is Yaz? Women need to know!'

Today Ms. magazine posted a piece I wrote regarding recent developments surrounding Yaz and Yasmin. As I outline here, and to quickly precis - it has been discovered in the last couple of months that Bayer intentionally hid research regarding the drugs' blood clot-causing risks. Multiple pieces of new research have shown these two birth control pills, and any of the generic kinds that contain the same synthetic progesterone - drospirenone, hold a risk of causing the women using them to develop a blood clot at a rate that is 50% to 75% higher than other birth control pills. The FDA called for a reappraisal. The decision made by a panel of advisers to the FDA had the potential to take Yaz and Yasmin off the market. The panel voted by a slim margin to keep the pills available, stating that the benefits outweighed these risks. An independent watchdog group - POGO - investigated and found that at least four of the advisers had significant financial ties to Bayer (the pharmaceutical company that makes Yaz and Yasmin). Anyway, I'll let you read the piece at Ms. as I explain it far more clearly. But I would like to post a link to the letter written by representatives of POGO to the FDA which outlines this finding, and more:

POGO Letter

There has been very little media coverage. The Washington Monthly published this very thorough article:


'The Yaz Men.'


Otherwise, there was Jezebel, the women's issues-orientated blog. The only other feminist or female-centric blog I could find that covered this story. I would have been pleased if they hadn't written something so very arrogant and ignorant.


'New FDA Decisions Don't Mean Birth Control Is Killing You.'


Right within the first paragraph the Jezebel writer claims to be more concerned (and angry, apparently) that there was ANY coverage of the FDA reappraisal and the findings regarding the blood clot risks, than that this massively important information on one of the most popular birth control pills had been at first covered up and then disregarded. According to this piece we should have all just shut up and kept quiet about our concerns over Yaz. All the women that suffered with blood clots - and as a result heart attacks and strokes - should have kept their problems to themselves. The families of the women who died should have stayed silent. Why? Because talking about Yaz and Yasmin having a 50% to 75% higher likelihood of seriously injuring or killing you than other birth control pills is going to make women stop taking the Pill. And women who stop taking the Pill become pregnant. So women like this one here:


'My Birth Control Gave Me A Pulmonary Embolism.'


Well, according to Jezebel, they just don't deserve the attention. I was horrified to read this piece. I couldn't believe Jezebel could publish and support such backward logic. I'm so angered by this post that I hate to even link to it here. Jezebel doesn't fully explain exactly what the new findings on these drugs say, the writer just skips right to telling us that we shouldn't be worried because all things considered pregnancy holds a much higher risk of giving you a blood clot.

Like I've said in my Ms. piece this suggests that there are only two states of being women get to live in - pregnant or on hormonal birth control. Strange that, as I've lived in an entirely different state - still fertile, not pregnant, not even a scare, and using condoms,spermicide and fertility awareness for my birth control. Non-hormonal methods of contraception hold no risk of blood clots. None. But I saw not one article remark on these alternatives. Surely if we are so worried that women will be scared into coming off the Pill then we should at least educate them on their other choices to prevent pregnancies? Instead, Jezebel decides we all just need to stop criticizing the Pill. We shouldn't let women know the dangers involved. They're too dumb to understand fully and they'll just go and get pregnant - is Jezebel's message. Talk about 'Trust Women' ! - this is the name of a new campaign advocating access to birth control.

The writer decides that Jezebel is not 'the media' (which is talked about more and more so as though it were a entirely separate entity to society and not just a bunch of people working jobs like writing and editing and living in the same world as everyone else). 'The media' - this piece says - is unable to convey information in a 'non-hysterical' fashion. If 'the media' is hysterical then I think Jezebel fits right in. What could be more reactionary and hysterical of a supposed feminist blog than saying, in the wake of very important findings regarding a very popular drug used solely by women, to say we should all just shut up about it because otherwise we'll have an unwanted baby epidemic on our hands. Rather than presenting the information and considering that perhaps the reason women come off the Pill and get pregnant accidentally as a result is because they are not properly informed of all their choices and have little to no body literacy as a result of the Pill hegemony.

Jezebel doesn't think there's anything 'scandalous' about these drugs. The writer mixes up moral objections to birth control with practical, real world, actual scientific findings that are making an important point about one particular kind of birth control that many, many women use. In conclusion, she says that criticism of the Pill plays into the hands of far-right wingers who want to ban it. It's true that the neo-conservatives are preventing women from understanding their choices. The conservatives are preventing accurate information coming out, yes, but they're having a lot of help from writers like this who are doing the exact same thing. The conservatives are doing it to supposedly protect women from sex, and protect society from sex, and the Jezebel feminists are doing it because? They love the Pill unconditionally? They want to protect women from real knowledge of their own bodies? They are just plain hell-bent on stopping unwanted pregnancies no matter what the cost? That's funny, because I think there are conservatives who believe that's what they're doing too.

I do happen to find the Pill 'morally objectionable' and I am not a neo-con or far right-winger. I have an agenda. Jezebel tries to pretend it does not. My agenda is to raise awareness of the potential negative physical and emotional impact of the birth control pill. It is to make women aware this is not their only choice. It is to ask that women view the Pill with a critical eye and not just swallow the mostly falsified information they receive through doctors, teachers and yes, 'the media.' That includes you, Jezebel.

I was heartened to read the comments on this blog post, published by a website advocating the use of clean, environmentally-friendly cosmetics:

'What's Your Take On The Pill and What Happens When You Go Off It?'

I found it interesting that they included such a cautious disclaimer and introduction to the post. Although I don't 'judge' anyone who takes birth control pills (hey, I took them myself for ten years!), I do reserve the right to be as dogmatic as I want to be. In fact, I think considering the cacophony of voices promoting hormonal birth control, singing its praises and even sending out misleading half-truths in a bid to blind women - I take it as my absolute responsibility to rage loudly and as often as I can. I have for guest blog posts been asked to temper my views and I don't like to precisely because I feel the pro-Pill brigade (and by pro I mean zealously enthusiastic as a rule) don't need any of the help they'll gain by me being wishy washy about my thoughts.

That said, this post was heartening as many women offered sound advice for how to cope with coming off the Pill. Particularly regarding the blogger's concern of increased acne. This is what women need - open, honest discussion about how the Pill effects their lives. I have often heard women say their main fear for coming off the Pill is the return of acne. I myself struggled with this. I still do. I am in the process, two years off the Pill, of cleaning out my diet to address lingering issues. However, I know that if bad skin is the price to be paid for not being on the Pill - considering how brilliantly improved the rest of my life has been as a result - I can get by. I find it interesting that these women seem to have arrived at the decision to come off the Pill via an interest in healthy diet and environmentalism. For me, it seems to be the other way around - once I came off the Pill I started looking critically at the rest of what I was putting in and on my body. I started wondering what other half-truths I had been fed. I started looking into the health benefits I'd assumed - not without help - to be found in meat and dairy, for example. I am now vegan.

The writer says she was on the Pill for two years and decided to come off. She explains why:

"The best way I can put it is, I sort of felt like a prisoner in my own body. I’m not sure why, and no, I can’t elaborate, but something never felt quite right. It was FINE. But FINE has never been all that appealing to me."

She also didn't have her period for a year after coming off. This happens to so many more women than the explanations suggest. I read again and again how the Pill doesn't impact beyond the time you stop taking it. To be honest, I sometimes feel that somewhere between its chemical impact and the psychological pathways it built in my brain, I will never be the person I would have been if I hadn't taken the Pill. When you spend so long anxious, depressed and paranoid - the synapses in your mind become fused to make you react to certain situations in a way that is more stressy than is strictly necessary. It's like, you come off the Pill and THEN you also have to deprogram yourself from all the behaviours you'd come to use to cope with how the Pill made you feel.

However in the last two years I have changed jobs several times, most recently taken on more responsibility than I've had in any position previously, got and stayed married, moved to a city I'd only visited for one week and all without having a nervous breakdown. I think this suggests what I experienced when on Yaz was not due to stressful circumstances. That I was taking Yaz when I was racked with fear, dread and anxiety was not a coincidence. I'm going to say, and I'll keep on saying it (loudly, so Jezebel can hear through their arrogant bubble) that coming off the Pill was one of the best decisions of my life. My experience of life has entirely changed for the better. I would never take the Pill again.

This week I called up one of the main lawyers involved in the 10,000 law suits against Bayer. I called up the US Drug Watchdog group. They both said they could not believe there was not more of an outcry over the FDA ruling that Yaz and Yasmin's benefits outweigh their risks. Especially considering the corruption that helped this decision come about.

Let's quickly recap that these drugs prevent pregnancy with the same effectiveness as all other birth control pills. So, the FDA was saying which benefits of these drugs exactly outweigh the risks? Their ability to clear up acne and prevent bloating? Because if so, that is ridiculous.

I said in response that I knew too well why there wasn't an outcry and it had to do with no coverage in magazines or on TV, sure, but it also had to do with the fact that we're not allowed to talk about it. We are not allowed to criticize the Pill - and that includes Yaz and Yasmin - and that includes even if they injure and kill women. Thank you Ms. for publishing my post. Please share it around. Not for my ego, but because it is vitally important.

Wednesday, February 1, 2012

Constructive criticism

There have been two very important and insightful events in the last couple of months. The FDA investigation into Yaz I will be writing on this week, once my piece for the Ms. blog has been published. Today the pharmaceutical company Pfizer announced a recall on one million packets of their birth control pills. Errors during processing caused these packets to have inactive sugar pills placed out of sequence - putting women at risk of becoming pregnant. I was quoted for The Washington Post health blog this morning (quotes taken from a piece published on the 50th anniversary of the Pill):


'Pfizer recall the newest troubling development around birth control.'


I was then contacted by the writer for my reaction to this event. I am happy to see this article draw attention back to the Yaz debacle as it is otherwise being conveniently hustled out of sight. Here is how I responded:

Although I feel anxious for those women who will be effected by the Pfizer recall (and I ask, who will help with the ensuing medical costs of those who do get pregnant? Will there be compensation for those wanting an abortion but not those who decide to continue with the pregnancy?), I do hope that this event puts women using birth control pills back in touch with the reality of taking a pill every day. I hope it reminds us all that the Pill is a drug (and a product of a billion dollar industry) and should as such be viewed with a critical eye. Women are encouraged by medical authorities and society as a whole to take a powerful drug every day, often for a decade or more, often from when they are in their teens. We need to discuss this fact and ask why.

Much discussion skirts around the reality of the Pill - see for example the recent 'new' research reported as finding that the Pill treats period pain. The Pill does not prevent period pain, the Pill prevents periods. Many women do not even know this, they do not know the bleeding that occurs inbetween packets is a withdrawal bleed and not menstruation. They believe the Pill regulates periods, when it does not. I think considering there are millions of women on this drug that this situation seriously questions the validity of their assumed informed consent.

What is interesting to me here is that in the reports on the Yaz findings it was emphasized that there are far more health risks involved in being pregnant than being on the Pill. In the reports on the Pfizer recall the emphasis is that the pills hold no 'safety risks.' Well, which is it? Either pregnancy is a safety risk, a state that is bad for your health, an illness to be avoided - as is so often emphasized by medical authorities and surrounding media in birth control discussions, or it is not. We cannot manipulate truths and half-truths to produce propaganda for the Pill and hormonal contraceptives as a whole. If women who have taken the drug can get pregnant accidently well within the usual logic of these discussions the pills do hold a safety risk. And again, who is going to compensate them for the risks involved in any ensuing pregnancies that the women decide to go through with? Pfizer?

Of course women do not only have two states of existence to choose from - pregnancy or on the Pill. If women are scared into coming off the Pill, as many will fear, by these reports on Bayer and Pfizer's products and they get pregnant as a result this only goes to show how women are not being given proper information about alternative contraception methods. There are alternatives and some are as, if not more, effective at preventing pregnancy. And all of them hold far fewer health risks than hormonal contraceptives.

I hope women are led to question their trust of the Pill because of these events. I hope that we as a society are forced to take the Pill off its pedestal and elevate the non-hormonal alternatives, make them more visible and talk honestly about their use and reliability. I hope women consider educating themselves about their bodies. Understanding their own cycle is key to prevention of unwanted pregnancy whatever method of contraception they choose to use. The dominance of the Pill over alternatives in birth control discussion does in itself cause women to take it incorrectly, miss pills, become pregnant, precisely because they are so often kept in the dark as to the reality of how it works on their body and how their body works. The information most often available is always misleading and slanted - I believe to support the billion dollar pharmaceutical industry that has been getting an easy ride on its most widely used medications for far too long.