Sweetening The Pill

Why can't we criticize the Pill?

2012-02-14T13:22:00.000-08:00

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.

Hysteric

2012-02-09T21:39:00.000-08:00

'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.

Constructive criticism

2012-02-01T12:39:00.000-08:00

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.

"Less stressed, thinner and more interested in sex."

2012-01-15T13:20:00.000-08:00

'Off the Pill, Off the Magazines.'

I've written another guest post for re:Cycling - the Society for Menstrual Cycle Research's blog. It is a great source of information and alternative opinions regarding periods, the Pill and body politics in general.

As you'll see, the title quote comes from a doctor responding to the question - how would I be different if I hadn't taken the Pill for the last ten years?

In my own experience coming off the Pill made me swap celebrity news and diet tips for the New Yorker and the Atlantic. On the Pill, these magazines were cheering; off the Pill they are either boring or depressing. When I was on the Pill I was always looking for something outside of myself to make me feel better and for answers as to why I felt so low and anxious. I had thought it was down to my life lacking in comparison to those celebrated in the magazines. I didn't consider it might be to do with the birth control I was using. On the Pill I couldn't concentrate or think clearly enough to enjoy an essay, now I will tear through an issue of them in a day. And then turn around and try to write my own.

Update: I will soon be posting here on the latest developments on Yaz - an FDA appraisal, the revelation of industry ties - which I am currently working on for a women's activist website. In the meantime, it has been discovered that the pharmaceutical company behind Yaz - Bayer - paid the women's magazine Allure to include a feature advocating Yaz in one of its issues in the first months of the drug's release. I don't think I'm a conspiracy theorist for suggesting that if they paid Allure, they probably paid other magazines too. I distinctly remember seeing Yaz mentioned in UK women's magazines which don't even hold direct-to-consumer drug adverts.

"and that the Pill robbed me of six years of my life."

2012-01-11T13:13:00.000-08:00

I find it very...eerie I guess would be the right word...that many women share the exact same experiences when taking the Pill. The sense of fear and dread, the same paranoid thoughts of impending violence and destruction, the suspicion, the inability to be creative.

My friend Suzanne's story shares a lot of similarities with my own, and with the story of the woman I quoted in my last post. I feel it lends support, if more were needed by the still skeptical, that it is the Pill that is behind these psychological issues and not just the dramas of each woman's individual life experiences as I have often heard argued.

Suzanne told me her story soon after I made my decision to come off the Pill - I was going through difficult withdrawal symptoms both physical and mental and she gave me much support although at the time we did not know each other very well. I took comfort in the fact that she had gone through this too, and was now well. I also found comfort and strength in her ability, as a creative writer by profession, to capture her experience with a very expressive and thoughtful choice of words. I often find myself using her turns of phrase to describe to others the potential impact of the Pill. In describing her feelings so eloquently she allowed me to place my own and then take control over these feelings and not let them run wild with my sense of self and sanity. I too had at one point considered I was developing a mental illness, so severe was my emotional breakdown. Talking with Suzanne helped me understand which parts of my experience were me and which were down to the Pill.

I have been off the Pill for just over two years now. During that time I have moved cities, living many miles away from my family and my closest friends, and had three job changes (far more upheaval and drama than I experienced during my worst time on the Pill, with Yasmin). I have felt calm and clear-headed and confident throughout this time. I plan on soon detailing a comparison of my reactions and feelings between my time on the Pill and my time off the Pill, as precisely as I can. But for now, I will let Suzanne take over, and just say that I am constantly delighting in my current Pill-free sense of well-being. Suzanne:

"I went on the birth control pill Ortho-Micronor in the autumn of 1991. I was eighteen and in my first serious sexual relationship, so terrified of getting pregnant I didn’t worry about any possible side effects, except maybe blood clots.

My mom became pregnant with me in 1973 after reading an article about a woman her age dying of a blood clot attributed to taking the older pills with much higher doses of hormones. Once my doctor reassured me that blood clots were rare, especially in someone my age, I started on the pill.

I had no idea what I was signing up for.

I never had bad skin, but my doctor put me on Ortho-Micronor, touting its ability to clear up acne. Within a month of taking the pill, my skin started to look different. It began to develop a dewy sheen, as if I lived in a perpetual state of afterglow. I enjoyed this new, fresh look and didn’t notice anything much different about the rest of my body, except for the fact that I stopped wanting to have sex with my boyfriend.

My libido died. And I was still technically a teenager. It wasn’t so much that I wasn’t attracted to him anymore. The thought of having sex just literally never entered my mind.

At the six-month point of being on Ortho-Micronor I started to lose weight. Of course I saw this as another unexpected bonus, dropping thirty pounds in the course of a year. What looked near anorexic to other people I interpreted as sexy, young, light. Except I was also losing my hair in large clumps when I showered.

After a year on the pill I switched boyfriends. This new boy loved to travel, but I was finding it hard not to feel paranoid almost constantly. I had stopped writing, which is the art form I decided to pursue in my life, stopped having any creative thoughts at all, stopped seeing friends, having sex. I felt afraid everywhere we went that we would either get in a fatal car accident or be murdered. I had never had thoughts like this in my life and was afraid I was exhibiting early signs of schizophrenia.

Once my periods became erratic even on Ortho-Micronor, I went off the pill and realized I wasn’t even attracted to my boyfriend anymore. I didn’t relate or find pleasure with his body, his scent, his way of moving through the world. We broke up. He accused me of becoming demanding and of acting crazy. I cried all the time. For no reason at all.

I went back on the pill in 2006 right before getting married. I was afraid of relying on condoms, and they seemed to be a barrier between my soon-to-be husband and I. I craved intimacy, and felt condoms stood in the way of that. It seemed ridiculous to marry a person and never even know what his body felt like moving inside of me.

This time, at thirty-two, the doctor prescribed a pill with a different combination of hormones - Ortho-Novum. I was nearing the age of concern over blood clots. Right away, in less than a month of taking this new pill, I felt awful. Bloated. Sad all the time. Not only did I lose my libido again, sex became extremely painful. So painful I could only tolerate having intercourse the one week a month I was off the pill. Sometimes sex made me bleed, my body felt so delicate. I could not be touched anywhere on my body without feeling overly sensitive. Oral sex became the only thing that felt bearable, and even that didn’t afford the pleasure I was used to before taking the pill. My own scent changed. I didn’t smell or feel sexual anymore.

My husband and I had this nightly ritual of listening to the Coast-to-Coast Radio Show in bed before falling asleep. I have always loved shows about aliens, monsters, those things that go bump in the night. While I was taking this new pill I again felt paranoid, like I was literally losing my mind. My husband looked at me with deep concern when I told him not to camp in the desert anymore for fear that he might be abducted by aliens. But if he dared bring up going off the pill, trying to hold me and reassure me that sex was wonderful with condoms and that he could not tell a huge difference either way, I accused him of being grossly insensitive, then cried myself to sleep.

Again I stopped writing, which by this point had become my occupation. I have no real memory of those years year on the new pill except sort of floating through them, dissociated from both my body and my mind.

I decided to go off the new pill when I developed break-through bleeding and read that, in rare instances, one can become pregnant even while on the pill. I instantly missed the intimacy of not having to use condoms, but I felt, after a month of coming off the pill, which included night sweats, insomnia, crying jags and strange resentment towards everyone, that I was regaining my sense of self.

The pill had caused me to fold in on myself, to become a zombie instead of a functioning woman. I learned to understand what being fertile feels like, that the times I felt sexual or didn’t were normal, cyclical, and that the suppression of hormones by taking the pill had robbed me of six years of my life.

I feel like I was frozen in time those years I took the pill. I have regained my sexuality and my sanity. Even though my regular menstrual cycle returned within a few months, it took about a year to feel normal again.

The most insidious aspect of being on the pill is the fact that, while on it, I didn’t even realize anything was wrong. I was irrational and reactive, could not remember that sex isn’t supposed to hurt, that it is abnormal to feel a sense of constant and persistent dread, and that my husband being abducted by aliens out in the desert is the least of my daily concerns."

Occupy Yourself

2012-01-08T17:00:00.000-08:00

As I posted recently I wrote a piece for feminist blog The F Bomb regarding specifically teenage women and their decision to take the Pill. I received some quite aggressive criticism from one commenter that made me very thoughtful about why I have not posted on this blog for around a year. Essentially her main argument was that my experience had no significance. Here's a quote:

"(Your) experiences don’t belong in this article as any kind of evidence towards a broader social/ medical problem for every girl, so I hope you just intended it as unnecessary back story. The way you made your personal decisions has little to do with anyone else."

Also -

"You’ve especially avoided facing the realization that your personal experiences have nothing to do with anyone else."

More significant, in her view, is the pharmaceutical companies' research. Despite the fact that the reason the company behind Yaz was recently scrutinized is that a large number of individual women's experiences of blood clots and the resulting health problems, as a consequence of taking Yaz, came to light. It was discovered that the company - Bayer - had covered up findings that the progesterone used in this Pill - drospirenone - held, in its make up and ratio to the estrogen component, an increased risk of producing blood clots. However unsound the argument against the importance of personal experience, I had to acknowledge it is this particular brand of criticism that has deterred me for months from writing on the Pill.

I didn't believe any less in the validity of my position - and I was getting and still do get emails from women frequently who have had very similar experiences to me (which I hope to soon share here) - but I was told over and over that my thoughts have no significance without a medical background for support, and without citable published research. Of course, if we had lots of citable published research on the direct emotional and psychological impact of the Pill - well, then I wouldn't need to be writing this blog. Even as the F Bomb commenter was arguing her point, someone else detailed their own story in this comment:

"I stopped taking the Pill because I was single and simply didn’t feel like renewing my prescription. Within that same month or two I started feeling really positive, awake, and alive. It was so dramatic that people around me noticed the change. I eventually realized that this burst of joy – which has not subsided in the three years I have been off the Pill – synced up with when I quit the Pill. I had been depressed for so long that I did not even know I was depressed. I thought that I was just an unhappy person."

My decision to stop taking the Pill was instigated by my reading the experiences of other women in forums and on comments boards. The lack of articles in magazines I read that criticized the Pill, alongside the consistent qualification of any research that did surface in the newspapers regarding negative effects with a hasty celebration of the Pill's otherwise resounding goodness is a huge part of why I kept taking the Pill long after it had truly turned on me and ruined my physical and mental health. If there had been other voices out there I may have questioned my decision to blame myself for my radical change in personality and endless illnesses earlier on and saved myself, and those around me, from a lot of suffering.

Although I have never pushed my views on friends in conversation - although most are aware of how I feel about the Pill - a number of friends and acquaintances have come off the Pill since I started this blog, often several months after I first mentioned my experience to them. In all cases the change has been positive. I plan to have some of them share their stories here too. One acquaintance (we went to high school together), who got in touch way back when I first started writing on this subject and whose comment that coming off the Pill was for her 'life-changing' really set me on the path to produce this blog, recently wrote to me to fill out her experience further. Here's what she said:

"I feel so strongly about this, but I haven't managed to convince any of my friends re: my experiences of coming off the Pill.I'm sure you've read that news story that reported that women on the Pill are attracted to different men than women who are not on the Pill? When I read this it TOTALLY confirmed my experiences of being on the Pill and I really think it's REALLY scary, that we could choose our life partners based on fake hormones that skew who we're attracted too.I think the report also said that women on the Pill are less satisfied with their sex lives, and this too confirms what I went through. When I exclaim to friends and family about this, (especially friends in long term relationships, on the Pill and dissatisfied with sex life - a recurring theme)no-one seems to care or believe me, so reading this was like YES!

I'd been on the Pill for 10 years, having originally been prescribed it for my teenage acne, then I carried on taking it for extra double strength contraception - but without thinking about or knowing about possible side effects. Then when I was 26, I suddenly decided I'd had enough. I think it was hitting the 10 year mark that did it. I felt like a cloud had been lifted, as if before I had been living in black and white and now i was living in full colour. I know this sounds mad, but it felt like I was just more alive. I also had these feelings of being more womanly, more attractive and more sexual and sexually powerful. People commented that I had blossomed and it really felt like that too. I just felt things more, more feelings of lust especially.

What I found most surprising was that I also felt so much more creative. I am a textile designer, and it felt like all my creative juices were flowing, so I wonder if there is a link between hormones, sexual feelings and creativity? I don't know but I really did feel like I'd been awakened creatively too. That is how I would describe the experience of coming off the pill - an awakening. And feeling really alive. And I would never go back on it, as I want to experience the real me. I must say my PMT is REALLY obvious now but I kind of love that, as I relish really feeling the true experience of the rhythm of my cycle."

This one young woman's brief comment on my blog spurred me on to keep documenting my experience of coming off the Pill, to hunt down some space in a national newspaper for my story and seek out interview opportunities. I like to think that for every one woman who emails me saying she was inspired to come off the Pill, that there are many more who got up the courage to do so too.

As we enter this new year I believe there is a perfect storm brewing for a real reassessment of what the Pill is truly doing for us. The Occupy Wall Street movement expressed and spread sentiments that I'd previously only heard from those deemed radical in their politics. People are questioning institutions that many have always felt were working to protect us. Of course, they should be working for our good but they aren't. The food industry is coming under scrutiny with more and more people turning away from meat and dairy in protest of its reckless disregard for not only our health, but the environment. Doubts once kept to the margins are becoming mainstream. It's the right time to question the Pill - and the pharmaceutical industry as a whole - and see the Pill for what it really is - a product.

Again and again I hear from women who say the Pill made them feel disconnected, repressed, deadened. Through reconnecting with our bodies, and as such our selves we are in a better position of connecting with others, and with the natural world. This connection is vital for any changes to be made to reverse the damage being done by the institutions that have revealed their agenda. On the Pill I felt divorced from my reality, and from reality as a whole. I was shut off, behind a veil, muted. I was in no state to do anything more than deal day to day with the stress and strain even the slightest conflict caused in me. The recent appraisal of Bayer for its promotion of Yaz has revealed its agenda, and it doesn't include helping or protecting women.

Ridding myself of the Pill made me ask a lot more questions about the rightness of many of the things I have been told throughout my life. A culture supported my decision to take the Pill, even when it was making me sick. I'd always been more aware than most, I thought, but for this I was easily kept in the dark. I was brought up to question institutions. Many people start with worrying over what they eat, and then turn to the tablet they take every day. For me, it was the other way around - I stopped the Pill two years ago and only now I'm understanding such things as milk isn't actually the only source of calcium and that meat is not an essential source of protein. Other things too, knowledge that I think is always there within us, but somehow gets submerged.

There's a phrase going around right now - Occupy Yourself. To some it seems to mean being vigilant, conscious, aware of your place in the world. For others it means critically analyzing the thoughts and beliefs you've long held in your own mind to be true - in the same way occupying wall street is drawing attention to the problems within this system. Like Descartes said, take out all the apples and examine them for rotten parts before putting them back in the basket. I had to examine my long held beliefs about my body, my femininity and my cycle - and write them out in this blog - to be able to get off and stay off the Pill and understand why this was so important for me. The quote 'Be the change you want to see in the world' means to me something slightly altered in that when I was on the Pill I felt stagnant - physically, mentally, emotionally - I could not progress, I would get stuck in emotions and thoughts, I could not think clearly. I could not progress. Off the Pill, my body goes through changes through the month, waves and peaks and ebbs and flows and it all moves me - and this movement is energizing and galvanizing. My self is back in my body. I am occupying myself. Every new cycle spurs action. A revolution - in every sense of the word.

Step out of the system and back into yourself.

F Bomb

2011-12-12T15:09:00.000-08:00

I Was A Teen On Drugs

Feminist blog F Bomb today posted a piece I wrote specifically on the issue of teenage girls taking hormonal contraceptives. The blog was started by Julie Zeilinger when she was 17. In the piece I discuss how I began taking the Pill at that age with only very little knowledge of how it worked, or even how my own body worked, and the most of which pieced together from real-life stories in my sisters' magazines and school rumours. With young women now being pushed towards long-acting hormonal contraceptives - which weren't around ten years ago - discussion of the contraceptive choices presented by those responsible for the welfare of teenagers is more important than ever.

re:Cycling

2011-01-19T16:19:00.000-08:00

I have been writing posts for re:Cycling - the blog of the Society for Menstrual Cycle Research.

Don't Just Take Yaz, Be Yaz

The Don't Do Drugs

Long Live The Difference

Pill-pushers

Getting wellness

2010-06-01T21:02:00.000-07:00

I got the new issue of Bitch in the mail this week and inside was this brilliant article:

Eat, Pray, Spend

Now, I'm fully aware of the possibility that at this point everything I read might seem related to the birth control pill to me - the result of thinking too long on the same subject. However this piece discusses the idea of 'wellness' in such a way that I started making connections between Pill-taking, consumerism and self-improvement I had not previously considered.

I guess my last two posts have pondered on this thought that taking the Pill is a form of self-improvement, if we come from a place, and we all kind of do, in which femaleness is seen negatively. I have said that there's an underlying message to Pill pushing that women can be improved, made better by taking the Pill. I have also said that we could see taking the Pill as an effort to get beyond femaleness. I'm kind of getting more and more interested in what the Pill means in terms of gender construction. It's funny because right back when I started this blog I bought a book on Queer Theory, and at the time I wasn't sure why I thought it was relevant. Nine months later I understand how it fits, and have begun reading.

So, the article talks about 'priv-lit' by which the writer means the sort of books women authors produce about their journey to enlightenment, self-fulfillment, happiness - stuff like Eat, Pray, Love. These books are ostensibly about becoming a better person, or a more enlightened person through removing yourself from your normal life and heading to India, or a yoga retreat or a Thai beach or some other such place to realign your perception. The writer of this article questions what becoming 'better' means within this culture, or genre - and suggests at the bottom of all the talk of spirituality the adventures in self-improvement tend to be about the woman finding a man, looking more attractive and getting into a new-age, well-traveled glamorous lifestyle. The writer calls the journeys to enlightenment, or retreats, or other such plans 'wellness schemes' - and remarks on how the authors of such books have an 'obsession with wellness.' The word 'wellness' is interesting in that it implies that those who have not attained wellness are sick. 'Wellness' is deliberately vague, of course, and the book authors never really explain how they are hoping to change. All we get to see is the profits of their new found wellness - usually a new boyfriend, a tan, a yoga body.

The writer argues that these books promote materialism masked as empowerment. The road to wellness, as it is described, is expensive - the travel, the yoga gurus, the classes, the expensive cleansing foods, the time off work. Enlightenment more and more so involves a lot of spending. And if no one really knows what enlightenment is then the spending never need to end. Wellness is connected with the idea of 'wholeness' also. 'Wholeness' is again an interesting word as it suggests those who do not seek it are doomed to forever be missing something, to be broken. The writer states that the narrative of 'priv-lit' fits very well with mainstream misogyny. The overriding, shared story is that:

'Women are inherently and deeply flawed, in need of consistent improvement throughout their lives. Those who don't invest in addressing their flaws are ultimately doomed to make themselves, if not others, miserable.'

This is what got me coming up with Pill connections. The way the Pill is 'marketed' either directly with commercials, or through the press, or by medical authorities is as though taking the Pill, and shutting down the reproductive system as a result (particularly menstruation), is an action of self-improvement. Women are understood as intrinsically sick, faulty because of their reproductive systems. The natural elements of this system - monthly periods, changing emotional state - have been promoted as unhealthy and dangerous. The Pill is no longer just about birth control, it is about controlling femaleness. Women have come to accept that in being female they are flawed, therefore shutting down an essential indicator of femaleness must necessarily be improvement upon their bodies, their selves. We have seen in the marketing of Yasmin and Seasonique that women who take the Pill are understood as sexier, more attractive, glamorous even. In taking birth control pills women are made to believe they are achieving 'wellness' - both physically and socially, as with priv-lit.

The idea of improving on the female with the Pill is part of the wider consumer culture of constant self-improvement through consumption of things external to your self. The writer calls what the priv-lit authors attain as 'false wellness' - it is not empowered as they see it, because it is governed by the needs of the economy. The women are buying into a culture, not acting independently for their own needs - they are only responding to the needs created for them through the means consumerism provides. They are not rising above the society that makes them feel 'unwell' as women, but perpetuating assumptions that women are unwell and need to be made better. They are ingesting negative ideas of femaleness, and then acting against this in a way that only confirms the validity of the ideas.

The writer of the article points out that when priv-lit authors discuss becoming 'healthy' it is not as an end in itself - not to feel better, think clearer or improve their outlook - but as a means to an end - that is getting a man with their healthier looks. Therefore what they do to become 'healthy' - even if it is yoga and specially made juices - only has to make them look better, and could in fact make them feel less well - it doesn't matter. I had a conversation with a friend about the 'yoga body' and how basically it indicates wealth - it's a marker of an elite group who can afford to go to yoga class every day, in time and money. Tampons and sanitary towels used to be accessible, as I've mentioned before, to only rich women and so became regarded originally as signifiers of a glamorous, rich lifestyle. Yasmin is the most expensive birth control pill out, and has been advertised as a lifestyle drug for women leading 'Sex and the City' type lives. The Pill in general is a more expensive form of birth control, so it holds connections with manipulated ideas of aspirational living.

If we live in a consumer culture run through with messages of self-improvement, a culture that also has foundational negative beliefs about women, then how do we as women respond to that? By self-improving our selves out of our female-ness and towards 'maleness' or 'non-femaleness,' perhaps.

I hadn't thought before reading this article about how the Pill, and statins, medications - as I was discussing in my previous post - and the idea of improving on human biology, or making us less faulty, is one part of an entire culture that emphasises self-improvement through consumable additions to the self. Self-improvement is often linked to exterior indicators of improvement - attractiveness or just how you will be seen by others - which are made more important than improvements on health or quality of life. The writer also talks about how 'wellness' is shown to be achieved through sacrifice. Be that monetary, time or commitments - your self-fulfillment is ultimate. Taking the Pill is making a sacrifice in order to attain perceived perfection - physical and social.

In a way, we aren't any more primarily men or women, we are first and foremost consumers and it is most useful that what it is to be a man or a woman is separated from our experience of it, manipulated, repackaged and sold back to us. It is more useful that we do not know what it is to be a woman, that we do not 'own' this as such, but that we must buy into our womanhood. We must consume in order to be women. We must buy back our femaleness piece by piece.

We can talk about gender being a construct, how we only learn what it is to feel male or female socially, but the biggest constructors of gender are corporations wanting to sell us stuff. I wrote my dissertation back in college about how the idea of maleness and masculinity has changed over time - what it was to be a 'man' was different in the 1960s to what it was in the 1980s to what it is now - yet always the idea of some 'real' and 'original' essential masculinity has been manipulated in order to create new kinds of maleness. As the economy changed, the idea of maleness had to change - industrial to post-industrial and so on. I wrote about how the TV show Jackass reveals men trying to reclaim their male bodies through self-harm. Hurting themselves to feel the realness of their physicality. I should look that essay up and have a re-read. It suddenly feels very relevant.

A friend of mine who works with autistic young men was talking to me the other day about how autism can prevent people from being able to see and understand social constructs - such as how to behave when having dinner with a group of people or even the idea of what dinner is as opposed to just eating when and where you are hungry, how to buy something in a shop, or how to conduct your self in any social situation. This has to do with not being able to generalize, to see the similarity in situations and assume certain behaviour is necessary or required in that situation. Autistic people, she also said, often don't care about what other people think, because they have no way of understanding other people as, well, people I guess.

My friend pointed out that the bank, the school, the dinner party are social constructs but so is the idea of the 'self' - and she explained that autistic people don't have an idea of the 'self' as who they are as seen by other people. So, they don't care about how they need to present their selves in order to create a certain impact, or about creating a particular lifestyle that is a reflection of their self. They do what they want to do, not what they want to do in order to produce a 'self' and an effect as a result of that. I don't know whether autistic men display understanding of themselves as men as opposed to women, but I know my friend has mentioned that they don't often behave within a clear-cut sexuality boundaries. In fact I think she said that sometimes autistic people identify best as bisexual. I suppose if they don't care how people see them, or have a sense of 'self,' then why would they have a sense of gender?

If we see gender as a construct, we can also consider the self as a construct - within gender we act in ways and do things that are expressions of what we have learnt to be our 'self' - from others, from society. That 'self' fits in to as many boundaries as the overarching gender banner under which we perform - as 'male' or female.' The more consumed we become with self-presentation, the more distanced we become from our actual selves.

Priv-lit and its ideas of self-fulfillment displaces the 'self' from the reality of existing as a human being and how that actually feels. For this strand of consumer culture to be a success we must feel there is something missing and we must then go in search of becoming whole. We must feel incomplete, we must not feel like our true 'selves' - for this feeling to be created we must be separated from our self and have to buy that back bit by bit.

Taking the Pill is an effort in buying into an accepted form of femininity, of grasping and living in a socially understood concept of femaleness. It is consuming in order to achieve an identity that fits with the ideals we see presented. The Pill brings us closer to the perfect, closer to the image of female. The reality of female does not exist, the 'original' femininity is a manipulated construct. Discussion of how women are originally suggests biology rules and dictates, and as historically such thoughts have only justified the oppression of women, we have become happy to disregard biology and embrace concepts of femaleness that entirely deny not just biology, but humanity. Taking the Pill is also an act of conformism - showing a desire for similarity, sameness - for an unchanging, continuous, controlled state of being. It is an interior version of exterior conformism through body shape, hair color, appearance. It is homogenisation. Sounding a bit Baudrillard, it always seems to come back to him.

Taking ownership

2010-05-23T13:28:00.001-07:00

'The Pill helped me to own my identity as a woman and be in control of my life, my body and my future.'

In the final chapter of Elaine Tyler May's book America and The Pill she quotes a few of the women who got in contact with her through an online call-out for birth control stories. This statement struck me in particular, although they are all pretty fascinating. The woman speaking sees complexities in her taking the Pill, it is not just about preventing pregnancy. She understands that the Pill has ties to her female-ness, her gender. If you think I'm looking too deeply, imagine someone saying something similar about, say, a painkiller that they have to take three times a week, or an asthma inhaler they use every day.

It's a very grand description for a pill that is promoted as inconsequential, a drug that is protected from criticism, doled out as casually as if it were no different to chewable vitamins for children. In fact, the health 'benefits' of the Pill are exaggerated to such an extent - recall the headlines a few months back which stated, completely falsely as well as absurdly, that women on the Pill were 'less likely to die' - that although this is a drug given to healthy women, it is generally believed - again, quite absurdly, if we think about it - that taking this drug makes women healthier, and does not have any detrimental effects on her well-being. Much like vitamin supplements. It is generally believed the Pill shuts down organs as inconsequential as the tonsils. So then why would a woman taking the Pill believe it had anything to do with her 'identity'? Another woman quoted in the chapter states:

'It's a non-issue - like brushing my teeth.'

Teeth-brushing though, even, is something we are taught to do before we even know why we should do it, why it has any good consequence in our life. It is a ritual before it is a conscious action. We brush our teeth before we want to brush our teeth. In the US, there's a whole industry around teeth brushing, and some of the products that are part of that industry - the peroxide whitening paste for example - are not only more than is necessary to get teeth clean, but additions to the ritual that probably do more harm than good. Then think about the fluoride that is put in the water system to keep people's teeth plaque free. Interesting. Anyway, so the first statement connects the Pill with a woman's identity. This reminded me of how science was seen to be helping housewives in the 1950s with the introduction of the washing machine, the vacuum cleaner and so on.The economy, growing consumer-centric, was helping women whilst shaping what it was to be a woman. Not just responding to women's needs but suggesting their needs in order to satisfy them.

I mean, that's what consumerism is about, right? After people have what they need, then needs are created by the marketing from the makers of things to get people to feel like without having this or that item the invented need is not met. Washing machines made women's lives easier, but consumerism then created better washing machines, additions to washing machines, as well as generating an anxiety about cleanliness, the necessity for more and more outfits - so the machine made life easier in one way, but the industry around it, the concept around it almost, made life harder in a whole lot of other ways. The Pill was a new invention created for a need women expressed, but then the concept built around that invention produced other needs, anxieties that linked in and made sure that even when the original need was no longer as definite, the invention was still popular and wanted.

We create our identity, which is a concept of our self in a way, through buying stuff - what we wear, what music we own, what films we watch, what we eat, where we live, what car we own - this all feeds into the identity. At some point buying stuff was more so just buying stuff, before it became representative of who you are. We have got to a point where how we represent our selves is more important than who we are, it is who we are. We are expert self-marketers. We sell our 'selves' through Facebook. Our lives are more exterior than interior. Life has become performance. So it is understandable that a woman might describe the Pill as connected to her identity, using the language of the world we live in. And in the US this makes sense, as the Pill is advertised on television and in magazines and women buy it, and it is a big monthly purchase, so of course it would also be a part of consumer identity. In the UK women are given the Pill, for 'free,' and this holds a whole host of other issues.

The Pill let the woman 'own her identity as a woman' - without it therefore, we can assume, she wouldn't own her identity. Now, is this the socially created identity of 'woman' as a concept, or her identity as a woman as how she feels it is to be a woman? Perhaps this is indistinguishable. The Pill stops ovulation, stops menstruation, stops the hormonal cycle. By stopping these bodily events, the woman only then owns her identity. She takes possession of her body. She perhaps was, as many women are, alienated from her body. Frightened of it perhaps, suspicious, or at the least irritated, by its workings. If she doesn't own her body, then who does, before she takes the Pill?

Of course this has been talked about a lot - this idea that as teenage girls mature into women, they feel their bodies displaced by their realization of their physical attractiveness to men - as in Simon De Beauvoir's The Second Sex. When the Pill is prescribed to teenage girls it is like a drug for a personality disorder, a way of securing their body and mind, preventing the fracture. Yet it enables the fracture - it drives the problems in the 'right' direction, that is towards emphasis on the exterior, displaced sexuality and identity as performance. When you're a teenager and you take the Pill you stop getting heavy periods, your skin clears, your hair gets glossy and you feel 'grown up' - it's a short cut to the social concept of womanhood. I think the woman's statement also relates to my previous post regarding the idea of taking the Pill as getting beyond the female.

It could be said that the identity she speaks of is the social concept of female, an image she can only get close to by taking the Pill. All that I've said previously about how the Pill links up to long held ideas of what being a woman means, and how a woman should be - the sick, child-like woman glorified by the Victorians to the clean, quiet, ever-ready for sex woman celebrated in the present day - is part of the 'identity' of being a woman that is suggested by the statement. Taking ownership sounds rebellious, but it could easily mean committing fully to the identity that you are presented with daily, and that isn't rebellious at all. But if you don't really 'feel' the same as what you are told you are supposed to feel as a woman, or 'look' the same, or 'behave' the same even - then taking the Pill, and taking ownership as such, could be seen as a very active choice. The woman takes the Pill to fit, to make her independent way in society without distraction. As another woman says, quoted in the same chapter:

'I just couldn't picture a fully functioning society without the Pill, it's like asking what the impact of the telephone system is.'

This reads then that the Pill is both vital to upholding and indivisible from our present way of life. The Pill is necessary - society would not have continued without its existence. It is perhaps then, civilizing? It could be said that the implication of this statement is that women would not function without the Pill, and that would hold back the progression of society. The Pill is so important that to question its presence, its position would be anti-progressive. The telephone system was the original source, but the idea of the 'telephone' encompasses much more now than it did then. The Pill is vital to the system of our selves and vital to the system of the society in which we live. If it is this much more than a drug, it is easy to see why concerns about its impact on health and well-being are so blithely sidelined. It's not just the unwanted pregnancy rate that is at stake, it is everything as we know it. The Pill is said to be nothing because it is everything.

Elaine Tyler May noted that a significant percentage of the respondents to her request for Pill stories were not heterosexual, some were bisexual and many were homosexual - as they defined it. I am surprised this view wasn't raised when I was blogging for Bitch, I had not considered it before - that women who have relationships only with other women and are therefore not using the Pill for birth control, still use the Pill. Some of the bisexual woman, according to May, stated that they took the Pill even when seeing another woman and were irritated at having to justify this to their partner, who would sometimes assume it was because they were also sleeping with men. Why would a lesbian woman want to take the Pill? Well, it can be assumed, for all the reasons heterosexual women take the Pill - most of which don't have much to do with birth control.

May actually also highlights in one sentence that respondents often said they didn't use the Pill alone, but with condoms. Yet May's book barely otherwise acknowledges that the Pill is not taken only for birth control, it is not even necessarily the main reason, nor the most important reason women take it. Nearly all books about the Pill contextualize its creation, its acceptance, its popularity through discussion of the drug as purely birth control. Talking from this place is much simpler than talking within the reality of how the Pill is taken, why the Pill is taken.

I would be interested to know the transgender standpoint on the Pill, if a woman wants to be seen as man, and sees herself as a man, does she make the choice to take the Pill so that she doesn't have to have periods? This is an intriguing point. I recall reading a study in which a medication including the synthetic progesterone drospirenone which is part of Yasmin, but also used in drugs created for transgender women who want to suppress their testosterone production, was tested on a group of transgender volunteers for its impact on cognitive function.

Chris Bobel's book New Blood: Third Wave Feminism and the Politics of Menstruation talks very intelligently and fascinatingly about how the radical menstruation activist movement is made up of mostly non-heterosexual identifying people. She discusses their views on having, stopping and hiding periods. Some see stopping and hiding periods as the mark of corporate ownership of our bodies. Being open and honest about periods is part of their belief that people should assess their identity as independent and critical of the pressures of consumerism. They try to separate out what they want, feel and like from what they are encouraged to want, feel and like and to construct their selves outside of the boundaries of what fits.

May - who, by the way has some oddly old-fashioned opinions on sex that rise to the surface throughout her book - quotes one non-heterosexual identifying respondent as saying:

'The Pill became a form of abuse. I would take it straight through for months at a time so as to miss my period and be able to have sex like a man.'

A whole world of concepts in that couple of sentences.

Un-birthday

2010-05-14T19:13:00.000-07:00

Since my last post it's been the 50th anniversary of the Pill. This event produced many, many articles glowing in their regard, and packed with some amazing hyperbole. I'm a journalist, so I get that when there's a certain space to fill in a newspaper it is sometimes necessary to create a story, a tale and it doesn't necessarily have to be true, it just has to be easy to write, easy to wrap up and require only a little research. Most people I've met in journalism would rather be writing novels, or song lyrics or short stories, so it makes sense to me that the 'news' can often have more in common with creative writing than the facts of what happened when and how.

I don't particularly mind that either, because I know what's more interesting for me to write, and to read. I recently read an article in the Atlantic magazine about how news has become homogenised, with most reportage relating the same information from the same viewpoint with the same angle. The Atlantic writer argued that for print journalism to sustain itself people need to start getting more creative about how they think and write about events.

For the 50th anniversary of the Pill the same old narrative was rolled out, which of course suggested the Pill not only liberated women, but that everything that has ever changed for women in the last half century is down to the Pill, that the Pill is the safest drug around and the only issue to contend with now is that access needs to be expanded so that more women can take it. Without the Pill women would not have been able to work, have careers and so on - I find this particular way of framing the narrative interesting because there were and there are many women who don't take the Pill and the logical extension of this argument is that any woman not on the Pill is not emancipated, and is still living an oppressed life, job-less, career-less, with ten children. If women did and do have careers without being on the Pill, that seems to serve to undermine the point.

Well, I'm being a little pretend-naive - of course, I am sure what this is supposed to mean is the mere existence of the Pill changed the situation of women and thereby created all that progress. But still, some articles really did lay out the idea that if not for the Pill, women would be having babies all over the place. The articles that were more clear on their history and acknowledged certain changes were underway long before the Pill came out still concluded with the same old, hackneyed lines about how the Pill is just amazing and we mustn't ever forget that. It's like the Pill is considered the same as the democratic vote, in that women fought long and hard for the 'right' and anyone who doesn't vote/take the Pill is ungrateful and ignorant. Kind of similar too in the fact that even when you have a vote, we're always faced with the same old choices - in the UK the public school old boy, here in the US pro-war Hilary or Sarah Palin. You can't vote outside of the system.

Women not taking the Pill are, like any minority, being squeezed out. An article on the Salon site written by a woman who found the Pill knocked out her libido calls non-Pill takers, 'Pill refugees' - and I have to say I felt a lot like that last week when I discovered I can only buy spermicide at one Rite-Aid in town and that only had two boxes left. The article was one of only three, excluding my own in The Independent, that took a critical stand - although two of those three again concluded with celebration. It's a bit like how the American president can suggest his country might need to change how it uses oil or how it eats, but he must always, always finish every slightly negative speech with the repetition of some patriotic nonsense about the Founding Fathers and Lincoln and Freedom. As such he can never really make any real changes, because he has to keep going over old ground and old ideas. He can never say, look we need to start over here, we got it all wrong.

Why I hate the Pill - Salon

Why I'll never take the Pill again - The Independent

Seek alternatives to the Pill - The Washington Post

The repetition of the Pill narrative reflects the ritual of millions of women taking a Pill each morning for years. As women pop the Pill they are ingesting all that the Pill means, everything it represents about how women are viewed, how they view themselves, their place in society. As we repeat the Pill story over and over we are confirming to ourselves the assumptions of that story - we are taking in again and again that the Pill liberated women, who needed the Pill to have careers and so on. It's like telling a fairytale, and like any fairytale it perpetuates traditional ideas, compounds traditional roles - and by traditional I mean the ideas and roles most useful and acceptable to those who get to decide.

The Salon piece came out the same time as some 'new' research showing that the Pill does indeed effect libido. Not much of a surprise there. It seems common knowledge these day, knowledge that is easily, happily accepted by most. I once had it pointed out to me that research into potential mood changes from the Pill, what there is, never only look at mood, but always link the study up with libido changes. The Salon writer admitted her lack of sex drive was coupled with a change in her emotional state, but only in that she felt bad about how it was impacting on her relationship, and therefore her self-esteem. The research scientist behind the latest libido statistics, Dr Irwin Goldstein, argued that a lowered libido can affect a woman's 'emotional well-being'.

The Pill's effect on libido and it's effect on mood are intertwined in discussion, suggesting it is the libido problem that creates the emotional issues, and that the emotional issues are only a conscious reaction to the change in libido. So, if a woman isn't interested in sex she will become depressed because she wants to be interested in sex, or her partner wants her to be interested in sex, or she feels she ought to be interested in sex. It is rare that you'll hear the emotional change put before the libido change in discussion - it is not usually stated that the Pill makes a woman depressed and if she is feeling depressed she is less likely to want to have sex.

That the emotional side effects of the Pill are not considered separately from the libido side effects shows how women's desire for sex is still being equated with their mental state. Depression, anxiety - these problems used to get lumped together under the heading 'hysteria' - and hysteria was thought to stem from women's reproductive organs and was understood to be generally curable through sexual release. Doctors would use all kinds of instruments to draw women out of their hysteria.

Making libido and emotional changes inseparable in research on the Pill and discussion of the Pill's non-physical impact allows for women's mood and well-being to be detached from their selves. Whether or not they are happy is dependent on whether or not they want to have sex with a man, how they feel about sex, their sex-related feelings. Their unhappiness is linked to their relationships, to other people, to how other people see and experience them. Making mood side effects about libido suggests a woman's emotional life does not exist independently of other people, of specifically I think we can say, men. If a woman is unhappy then, it is because she is not 'relating' to a man. Therefore - women's emotions are controllable by other people, by men, as her mental state is entirely dependent on her relationships and not on anything intrinsic to her self. She has no inner life, I guess I could say. She only reacts to exterior forces.

I suppose perhaps research scientists think it's easier to measure libido changes - a woman will not have sex as much if she doesn't want to, and that is an accountable figure. But as I've said before here, that's very simplistic and based on the male-model of sex and relationships. A man has an exterior physical sign of 'wanting' to have sex - although I think it could be debated as to whether that's true, that is what is accepted - so it can not be understood that a woman might have sex when she doesn't 'want' to physically. Asking women to keep detailed diaries of their day to day emotions and the events of their lives would work well, but also would just trusting women to know when they feel sad because something sad happened, and when they feel sad because of the drug they're taking. I am still astonished at how dismissive people can be of women's own readings of their own feelings.

Perhaps because women are subordinate to men within society, they are thought to be the creation of men. If they are man's creation then they only exist under men's terms. Female only exists because male exists - this binary. Of course, women give birth and create men as such, but if men get to lay out the narrative by which women live, then they are characters within a man's production and have no inner life other than that directly related to men. Doctors will still say they don't want to put ideas in women's heads by telling them about the potential side effects of the Pill, but it seems like more than an assumption of susceptibility. Like in the movies, how women are nearly always just vehicles for the central male character to fulfill his fate. Libido is sex, not sexuality. The Pill, in shutting down the hormone cycle, impacts on the development of a woman's sexuality, not just how she feels about having sex. We still don't like to consider female sexuality as separate from men, as not directed toward men, but as something independent.

So much talk concentrates on how the Pill changed sex, how people approached sex, but there's very little said on how the Pill changed sexuality. I discussed this some in the last post, and I've been lately reading America and The Pill, a book by Elaine Tyler May, in which she discusses the issues surrounding the development of a male Pill. She notes how there has always been much anxiety over how such a drug would effect 'masculinity' which is not only libido, but ideas of power, ego, how it feels to be a 'man.' It is widely accepted that the Pill effects women's libido but not her 'femininity' or her 'femaleness' - and perhaps this is because the Pill is seen to produce an improvement on women - getting rid of periods, assumed 'unpredictablity' and over-emotional qualities - and making her cleaner, quieter. The male Pill is seen as taking something away from men, whereas the female Pill is an addition. When it comes to women, the external is the most important. As long as she looks female.

May also discusses in the book how Hugh Hefner and Playboy really got behind the Pill when it was first released. Hefner saw it as allowing for 'uninhibited' sex. He advocated in a few areas of women's rights, but his campaigning had the overriding message of making women more open to sex, more interested in sex and more openly sexy. The Pill was good for porn, basically. Hefner believed women who did not want to take the Pill to be 'neurotic, prudish and hostile to men' and said as much in the pages of Playboy. Women should tolerate any side effects, he argued, because of the benefits for their 'sexuality' - by which he meant their enjoyment of sex. If women could have more sex, then of course their 'sexuality' would improve, because the quantity of sex is the only marker. Women's sexuality is only understood in relation to sex, not as independent of sex - not as regarding her own relationship with her body, or her understanding of her femaleness.

I have previously considered how the release of the Pill helped progress the capitalist/consumer economy - making more single people to buy more stuff and so on -and interestingly May's book brings out how the population control motivation behind the enthusiasm for the Pill has its origins partly in a belief that prevention of too many births would stop civil unrest that could lead to a brewing of communist ideas. If lots of poor people were being born, and they grew dissatisfied with their unequal lot, they might start thinking of the capitalist system as unfair and injust and the reason for their suffering and therefore start considering alternatives, like communism. The Pill was therefore seen, as she explains, to be 'opening up' new markets for capitalism, and helping its growth.

Over the anniversary time some other research was released that stated use of hormonal contraceptives increases the risk of a woman contracting HIV, increases the development of the virus and speeds the progression of the disease. Joan Robinson, a researcher for the Population Research Institute said that mounting evidence for this has been ignored. It is often argued population control efforts in developing countries are beneficial to women, allowing them to have only wanted children and lead healthier, freer lives, and also allowing for the countries to develop economically. This can not be the case if the women, and then of course the men, have HIV and little access to treatment. This entirely discredits the standpoint of those pushing the Pill on population control grounds. It is just another story that's told over and over, like a fairytale, and in being told is made 'true' - and beyond the reach of criticism.

All of this goes towards establishing one endless hum of a message - there is no alternative. No alternative to the Pill, no alternative to the way things are.

Beyond female

2010-04-22T14:46:00.000-07:00

During my time blogging for Bitch magazine I had the opportunity to untangle some of the issues surrounding any discussion of women and their bodies, and women's bodies. I suppose I considered these issues a little when I was at Mt Holyoke, meeting women who dressed like teenage boys and picked a different, man's name, to go by. What most fascinated me then was how they could know what being a man, as opposed to a woman, 'felt' like - and why it was necessary for them to go from 'woman' to 'man' and change their appearance - matching their outside to their inside. I guess even at that time, now I think about that as more than an interesting anecdote of my year at a private all-female college, I was thinking there wasn't really, truly anything in being male or female, and that for the most part this stuff was all constructed socially.

I wasn't sure I felt like a 'woman' - I just felt like me - and could relate to some women, and some men, and not others. I obviously didn't want to deal with the negative connotations of being a woman - and I figured that out through wondering why all the writers, filmmakers etc that I was interested in were men, and thinking about how my vicarious experience of life was through the eyes of men - how men were exciting not just because they were physically attractive, but because their position, their way of life, appeared more exciting to me.

I went to an all-girls school from the age of 11 to 17 too. At the time it certainly doesn't make you like being female. Men become fantasy figures - unreal - and, in a way, better for not being real. I was pretty scornful of the women at Mt Holyoke - there was a lot of underlying talk about how even the most rebellious, inventive students would end up married and working as accountants. When I'd left I got as frustrated with the idea of what it is to be a woman as any of us do.

I started this blog to raise awareness of what the Pill can do to women, how it can make them feel depressed, anxious and make them feel generally low and ill all the time. I wanted to write about this because it had taken me a long time and a lot of time to find out the Pill could do this and I didn't think it was fair that I hadn't known. That's still the reason I write this blog. However, in trying to work out why this stuff isn't talked about more widely I came to all kinds of conclusions and these conclusions have ended up expanding my understanding not just of the basics of female biology, or how completely not basic that biology is, but also this thing of being a woman and what that means.

So, yes, in talking about how the Pill effects women's bodies I have realised I am saying that biology is important, that female biology is important. I'm also highlighting that female bodies are different from male bodies. By suggesting a drug that changes female biology can negatively effect a woman's mood, I am arguing our experience of life is linked to our biology, even perhaps that who we are is linked to our biology. I am pointing out that the ovulatory cycle, a specifically female bodily system, isn't something that can be shut down and ignored without repercussion, because it is in itself vitally important to healthiness.

Now, little did I know when I began writing this blog that these statements would be so controversial - that even using the word 'female' would be so contentious. I'd been feeling like talking about women's bodies was considered risky, and that talking too loudly and illiciting too much attention could provide justification for arguments that women are weaker than men, less capable, more emotional and so on - and that would lead to no good. Women have long been trying to prove that their biology does not matter - because their biology is only seen socially, and historically, in the negative.

The Pill came out of socially acceptable ideas of the female body and perpetuates the negativity towards the female body - the suspicion, the fearfulness, the disgust. If we were as positive about the female body as we are about the male, we would not have the Pill - and we don't have a male Pill because it doesn't 'fit' into the line of history, and the progress of society, the way the female Pill does.

I recently read Chris Bobel's latest book, out in a couple of months, called New Blood: Third Wave Feminism and The Politics of Menstruation. Chris discusses 'smashing the binary' - that is getting rid of the concepts of man and woman - in relation to menstruation activism. Radical activists use the term 'menstruators' in place of 'women' - Chris looks at how such a move impacts on feminism. How useful is breaking down these boundaries she asks, when there is so much discrimination faced by women for being what is still understood as female? She considers whether it helps to say that male and female are social constructs, and work from there, or whether as we don't live in a post-gender world we would be making too much of a leap, and leaving a lot of people behind in doing this.

There's been quite a bit in the news lately about statins - these drugs that lower cholestrol - and they are being marketed as a drug everyone should take as a preventive action against heart problems. This is raising debate about whether healthy people should be on drugs long-term. To me, I need to talk about 'women' and 'femaleness' in talking about the Pill because it is integral to how the Pill came about, and why it came about, and why it's still taken by so many. But talking about the effect of the Pill is talking about human beings, people, quality of life and healthiness. I am not sure women should be pushed as they are into taking the Pill, but then I'm not an advocate for the creation of a male Pill either.

In Chris' book she points out that blaming biology for behaviour is 'classic' anti-feminist. So, in a way, that I write about how the Pill can change the way a woman feels, making her depressed by meddling with her biology 'reads' as anti-feminist. If I say the Pill made me feel terrible, I am saying my biology (my ovulatory cycle here) effects my behaviour, in that how I feel effects how I act. But Chris states that it is also anti-feminist to not take women at their word, and validate their experience. The blog Feministe criticised a Bitch post of mine with a piece that essentially said I should not be critical of the Pill because the religious Right is also critical of the Pill and I am only providing fodder for them. My experience was not valid because it does not fit with the 'feminist' agenda as Feministe sees it. I was seen as being 'anti-science' and science is understood to have liberated women. You can see more here:

Feministe response

I have to say when I was told I was ignorant for saying the Pill didn't 'regulate' periods I decided to stop arguing and let them just read this blog instead - as I have said before, for any new readers, the Pill does not regulate periods, it shuts down the ovulatory cycle, so you don't ovulate and you don't have periods. The bleeding that occurs is called a 'withdrawal bleed' and is not a period. Not every woman taking the Pill will have my experience, but they might have some part of it at some time in their lives - and every woman will not ovulate and this does, always, impact on the body. And the way things are arranged, most women don't get to know this.

I came across on the Bitch comments boards much that suggested the idea of 'overcoming' femaleness, the body. In taking the Pill some women argued they are taking control of their body, and that this action is empowering. They see their bodies, particularly their periods, as troublesome and irritating and are happy to have the ability to turn this part of their biology off. For some their periods are apparently very difficult, making them very uncomfortable every month. For others, periods were considered just a nuisance, an inconvenience. I was surprised to see many women repeat the statement otherwise used by dubious medical and pharmaceutical representatives, that it is not 'natural' for women to have as many periods as modern women do, because previously we would have been pregnant most of the time and not lived very long. It seems to me so clearly misogynistic, I couldn't quite believe Bitch readers could buy it. You can see all this here:

Reproductive Writes: Do We Need To Bleed?

I has never considered before that taking the Pill could be seen as getting 'beyond' femaleness - and as femaleness is understood mainly in the negative, escaping its confines could only be good and progressive. I am interested to see how many self-described feminists really seem to dislike being 'female' and having 'female' bodies - even without allowing that this is rooted in the fact that socially, and historically, female bodies have been seen as problematic and in need of male control, at best. I have spoken before of my own feelings about why I kept taking the Pill, even when I was aware it was making me feel unwell, and how I see that as bound up with my desire to control my body, which I found kind of scary - but only because I was on the Pill from 17 and never heard, saw, or experienced anything to do with my body that wasn't flooded with bad connotations.

After reading these comments at Bitch I talked with Elizabeth Kissling about the Seasonique adverts on television in which a group of women asks 'Who says you have to have twelve periods a year?' and the defiant statement 'Who says?' is repeated over and over. The authority that is being questioned is unclear - it could be other women, men, the pharmaceutical industry, feminists, or as Elizabeth said 'your mother' - the point is that the advert suggests these women are rebelling, by taking Seasonique, against authority. They are overcoming their biology, their femaleness - it is not just birth control, it is, as the Yaz tagline goes 'beyond birth control' - it is about being 'beyond female.' Female, in the way the advert suggests, which is rooted in the culture that suggests, female is not good, female is not something you want, female needs to be controlled, needs influencing and changing and directing and organizing into something neater, easier, less frightening.

The Pill when released was linked up with the idea of rebellion within the sexual revolution, the women's revolution. The Seasonique advert decades later splits this rebellion from any idea of the collective, into something individualistic - something that fits in with how the sexual revolution panned out, because never having periods is about, although this is not said, being 'available' for sex at all times.

When I finally saw this ad on television it made think of plastic surgery and how much criticism women who have plastic surgery come up against from other women, how negatively plastic surgery is considered. And plastic surgery is changing your body right? Controlling your body, being 'beyond' human in a sense, through changing your physicality, by not aging, not giving in to what your genes, your biology gave you. Does plastic surgery come under the banner of 'my body, my choice' - and if it does why is there so much talk about the psychological impact, the social impact of this choice? Why are people who have lots of plastic surgery a concern, but not people who take a drug to shut down their ovulatory cycle, stop their periods and 'perfect' their bodies from the inside out?

Science is equalised with progress and we are all for modifying and suppressing our bodily functions with 'science' as such to perfect our faulty bodies even when generally healthy and well and the notion of 'faulty' is spurious. Even if we are not ill, science - drugs - are making us better. Better humans. Better women. Statins might make us less faulty - less likely to have high cholestrol - but in what other ways will they make us ill and in what other ways can we deal with this faultiness that is not long-term drug use that impacts the whole body. The Pill is no longer about birth control, it is about being better, improved.

The commercial tagline for the brand Yasmin is 'Beyond birth control.' By moving the issue from birth control to menstruation suppression, or acne control, or mood control - pharmaceutical companies are betraying themselves. In medicalizing the healthy female body, and saying overtly it needs controlling, improving - they are betraying the very old-fashioned foundations of Pill promotion. Just as with the arguments on the Bitch comments board, the root of this talk is rotted. It's accepting that women's bodies are bad, and need to be made good. Capitalism is crafty, it will always find an avenue for assimilation. It's almost like the pharmaceutical companies have been listening at the door of late.

Development is the best contraceptive

2010-04-13T12:16:00.000-07:00

I've spoken of my suspicions of the population control arguments put forward in support of increasing use of hormonal birth control methods before. In response to the question of the Pill's potential side effects, it is often said that preventing women in developing countries having too many children overrides such concerns. This motivation translates into the myopic view of contraception in the Western world that is backed by a dogged desire to prevent unwanted pregnancy above all else.

As Laura Wershler said in a recent interview I conducted with her, and posted on the Bitch magazine site - unwanted pregnancy is the only acknowledged sign of health in young women.

Not Just Another Choice: Interview with Laura Wershler

As long as a young woman avoids unintended pregnancy, all is well. Although I'd suspected, and read a little, about how poverty has very little to do with population and a whole lot more to do with distribution of resources - I'd not quite got my head around the topic. So when I came across Betsy Hartmann's book Reproductive Rights and Wrongs: The Global Politics Of Population Control I was happy to see my unformed thoughts given some real substance.

She argues that it is not overpopulation that causes poverty, but a coupling of the subordination of women and the monopolization of too many resources by very few people. The belief that overpopulation is the source of the problem has what is described in this book as a 'boomerang' effect on developed countries attitude toward contraceptive research and distribution. The drive of reducing birth rates quickly and effectively dominates programs in developing countries, the US and across Europe. Health and safety concerns are swept aside in favour of high rates of success in preventing unwanted pregnancy. Hence the pushing of the Pill and now long-acting hormonal methods.

In developing countries women are oppressed - Hartmann thinks that if you reduce the system of patriachical power in a country, then you reduce the birth rate consequentially. If women are provided with support, opportunities to earn, independence and decision-making power then population can be stabilized. I've thought before how strange it was for feminists to bring out the population control argument in response to criticism of the Pill and whole-heartedly advocate the importance of preventing women in the Third World having children as it seemed to me to legitimise, or at least show an uncaring attitude toward, the unequal relationship between men and women in those countries. It seemed a bit to me like saying all American teenage girls should be put on the Pill because they might get raped by teenage boys, and preventing them having the resulting pregnancy is more important than dealing with the fact they're getting raped to such a degree that we need a blanket application of hormonal contraceptives.

If there is a high infant mortality rate then women will have more children with the knowledge that many of them may well die before they become adults. Women in poverty also need children to help them survive - to work, to take care of them as they grow older or if they become ill. I have never heard anyone suggest that these women may need, want or just plain have to have children and not want to use hormonal contraception to prevent this happening. Blaming their poverty and hunger on overpopulation allows for social injustice, allows for the oppression of women. So rattling out this argument, as many feminists did when I discussed this in terms of Depo Provera on my Bitch blog, is actually allowing for the oppression of women, and assuming their oppression in an inevitability.

The Rebranding of Birth Control

Hartmann calls population control a 'substitute' for social justice that holds back the emancipation of women. This is interesting to me, as I have said before the Pill could be seen as a substitute for real change in the Western world - changing women as it did, rather than changing society. The Pill only helped women to be assimilated into the male-created, masculinized social structure and allowed for the continued development of the consumer economy. It usefully blotted out long-held, and still held, concerns about women's bodies and reproductive abilities. It didn't address real issues between men and women, but compounded in a way their alienation from each other in order to progress a capitalistic society. I've wound around this all previously. It's like how sexual freedom is now used to show how free and independent women are, and is focussed on above all other areas of women's lives - as Ariel Levy talks about in Female Chauvanist Pigs or Natasha Walter in her new book Living Dolls - except without the Pill part of the discussion.

The Malthusian outlook that backs the population control argument denies that the rich play any part at all in keeping the poor, poor. Basically, it is just thought that the poor should stop being born. But there is no evidence to show population density causes a lack of resources and poverty. Hartmann points out that corporations that own much land in developing countries do push populations into unsuitable areas for farming and living in order to take advantage of better areas and make a profit. Plus governments in developing countries have different priorities to what they should, preventing change.

The emphasis on the most effective methods of contraception and not the safest or best for individual women that is produced by population control programs ensures that many women, once put on hormonal contraception, will experience side effects and soon stop taking the Pill or returning for their injection. If one woman has an adverse experience she will tell many more. Women in developing countries do not get told what to expect - then again, neither do most women in developed countries - and so when they experience problems they will just stop using that method. The inserts in Pill packets contain far less, and often no, information.

The linking argument here that is frequently used both for population control purposes and here in the US and Europe is that hormonal birth control is much less risky to a woman's health than pregnancy - an argument that has a lot of holes - but Hartmann suggests that the Pill and long-acting methods could cause far more health problems for women in the Third World. If a woman has low body weight, poor nutrition, poor sanitation and is not given any health screening prior to being put on the Pill she is far more likely to suffer side effects. In fact, considering how the Pill impacts on the metabolic system, preventing proper absorption of vitamins and promoting vitamin deficiency - this drug could actually be directly weakining women further and preventing them more so from having healthy children. Depo Provera, Hartmann notes, can cause continuous bleeding for some women - and women living in poverty cannot afford to loose the blood or the iron it contains.

In conclusion she argues that, as I have, the dominance of hormonal methods of contraception prevents the development of other methods and research into improvements or even new possibilities. Barrier methods are rarely improved upon and barely advertised in the US and Europe. I had much discussion at Bitch regarding negative attitudes towards condoms. Attitudes that could be turned around if the material used to make condoms was developed to produce a better feel and experience. I notice at my current cashiering day job people mostly buy novelty-type condoms with design additions supposed to improve the experience, so the market is there for a wholesale upgrade. Barrier methods are not considered for third world countries as a viable, effective option because it is understood that women would need the cooperation of men and with developing countries male/female relations as they are this would be difficult. Rather than addressing the root - that the oppression of women prevents the use of barrier methods - and therefore, importantly, increases the spread of HIV - it is thought better to push the Pill and injection on them.

Hartmann believes real reproductive choice relies on women having control over their lives and equal power to men.

I have just found out she is a professor at Hampshire College in Massachusetts, a school right near Mt Holyoke, where I studied for a year. Mt Holyoke is an all-girls place, and very political. At the time I took a lot of fun in sending up and skewering the feminist-like activism that went on and wrote essays about the plight of the American male as seen in Michael Douglas movies and Jackass. I guess all that influence filtered through over time, or fermented, or something, and here I am now writing this.

Other voices

2010-04-13T11:35:00.000-07:00

Enough of me - Julia De Laurentiis Johnson hails from Canada and is in her twenties. Here's her story of how she came to come off the Pill for good:

"After being on the Pill for a total of seven years, I was desperate to get off it. It made me feel bloated, stagnate and crazy. I now use a non-hormonal copper IUD and I will never use anything else if I can help it. I love it – it's zero-maintenance and hormone free – but the road to my contraceptive bliss was once helluva trial-by-fire.

In the roughly ten years I've been sexually active, I've used a number of different birth control methods. Being a 90's teenager, I was very well versed in sex education and responsibly used condoms and spermicide sponges when I first started having sex. When I got into my first serious relationship, I went on the Pill – in Canada they would start girls on Ortho Tri-Cyclen, an Estrogen and Progestin pill that was triphasic - three different 'phases' of pills in each pack - and each week the level of the Progestin hormone increased from 25 micrograms in the first week to 35 mcg by the third. I hated it and used it for just two months. After getting over the initial rush of feeling very grown up for being on the Pill, the side effects were too uncomfortable to ignore. I switched to Alesse, a monophastic single phase Pill with a lower hormone level and used it, without obvious incident, for five years.

A year after my steady boyfriend and I broke up, it dawned on me that I was a bit of a hypocrite. Generally, I tried to do good things for my body, like try to avoid processed foods, to use organic hygiene and cleaning products and to eliminate as many unnecessary chemicals from my life as possible - yet here I was systematically swallowing a drug every day, three weeks out of the month, all year long.

At the end of my five-year 'drug habit', I decided I really needed to get off the Pill and give my body a break. Soon after, I started dating someone new and sexual regularity was back in my life - I needed to seriously reconsider my contraception methods. I really didn't want to go back on the Pill and I really didn't want to go back to condoms. We weren't a terribly stable couple to begin with – and definitely not at the commitment level where an IUD or a quarterly Depo Provera hormonal shot would have been appropriate. If condoms are the undergrads of Contraception U and choosing to have an IUD sit in your cervix for years qualifies as a PhD, I felt I was at the stage in my sexual life where I was prepared to take on my Master's: a diaphragm.

I got fitted for my pastel pink latex diaphragm, which came in a pastel pink plastic carrying case, and seeing it peak out of my purse where I had shoved it under my sunglasses case to keep it discreet, I felt as if I had inadvertently become part of a terribly acted sex education video. That device did do the trick, though - i.e. kept me un-pregnant - but it was complicated: It removed a sense of spontaneity from sex, as I had to be excused in The Moment to fit myself with this domed sperm-net. It need to be filled with spermicide, took some manoeuvring to fit it up against my cervix and there it had to stay for an additional 6-10 hours after the act, just to be sure it'd done its job. My partner and I could both feel it, also a bit off-putting and it was still only 94% effective, 2% less then the Pill. But I appreciated that it was non-hormonal and figured that the inconvenience was worth it. When that relationship fizzled, so too did my diaphragm use.

By the time I entered into my current relationship, I'd let my ethics about non-hormonal contraception fall by the way side – I wanted an easy, reliable and totally convenient method of birth control. I was living in London at the time and studying for my Masters degree – I recognized that I didn't have the time or care to be fumbling around in the bathroom for the sake of contraception. So I put myself on a low-dose monophastic Pill called Loesterin and naively thought that it would negatively affect nothing, just as my first monophastic Pill hadn't, acting only as armour for my eggs.

Over the course of 18 months the negative effects of the Pill became obvious. Apart from constant bloat, I had developed bad psychological habits, including second-guessing myself, something that until then had not really been part of my personality. I would easily slide into emotional slumps, had a continuously running undercurrent of the 'blahs' and felt that I could never really focus, like there was a veil of mist across my brain. I'm not sure I had any suspicion that the Pill may be to blame, thinking instead that it was probably all my fault, really, and that I just wasn't trying hard enough to think clearly or positively – don't all women feel like this?

The real turning point came when my partner and I were to be apart for a few months and I decided to go off the Pill to give my body a break. Off the Pill I just felt so…alert. The bloat, discouraging thoughts and cloudy mind ebbed away; I felt like Dorothy discovering a colourful Oz. It made me certain that I was never going back to the Pill.

I read up on my contraceptive options and realized that a copper IUD was the obvious choice. This is why:

It's non-hormonal, which was my number one priority for my new birth control. The copper in the non-hormonal IUD interferes with how sperm is transported, diverting it from the egg. Science is cool.

Once inserted it can be practically forgotten. There's nothing to remember to take! Except for a yearly pap test to make sure everything's ticking along, there is no maintenance involved – sex can remain as spontaneous as it was while on the Pill. Ok I lied –this was my number one priority.

It's inexpensive, a one-time cost of $100-$200, often covered by health benefits and lasts for up to five years.

It's entirely reversible. If/when you want to get pregnant, just get it removed.

It's the greenest method of birth control. It doesn't just reduce physical waste (no pill packs or condoms to throw away) but hormonal waste as well. Not only has it been proven that Estrogen from Birth Control Pills flood the water system through sewage, disrupting fish sex organs but also that the hormone cannot be fully distilled out of our own drinking water and may adversely effect human male fertility. If I could do my part by not adding to the Estrogen-laden pee filling my community water filtration system, this counted as a plus.

Ok, here are the cons:

It takes a while to get set up. First, you need to book an information session with your gynaecologist. They run you through every possible pro and con to help make you certain it’s the right method for you. Then you get a pap test to determine everything in there is running fine, because it's about to get a long-term foreign roommate. Then you gotta wait a few weeks for the results.

It needs to be inserted by a medical practitioner. This means another appointment. They also give you pills to insert vaginally to numb the surrounding area a few hours before the procedure. These pills can make you cramp like a bitch.

Periods tend to be a bit heavier. If you already have heavy periods, this may not be for you.

The insertion: It's quick but it hurts like absolute hell. It isn't the actual insertion of the device that hurts, it's when they measure the depth of your cervix. It does only last a couple of minutes, and I did take extra strength pain pills beforehand, but it hurt, like the worst imaginable cramps and my body shook a bit from the shock. But then, as quickly as the pain comes, it dissipates. Soon afterward, you just feel a bit tender. Get yourself an ice cream.

If the idea of pain scares you, don't let it. Though, quite bizarrely, an estimated 2% of American women use the IUD it is intensely more popular around the world. If millions of women can do it, so can you.

I wish I could go back in time and tell that teenage contraceptive novice how much headache she could have saved herself."

Blogging at Bitch Magazine

2010-02-08T12:27:00.000-08:00

I blogged for Bitch magazine for two months under the title Reproductive Writes:

My profile

An Introduction

The Baby-Makers

The Model Home Birth

The Rebranding Of Birth Control

Do We Need To Bleed?

The Short-Cut To Sexy

A Pregnant Pause

A Fighting Chance For Choice

GaGa For Condoms

Get With The Program!

Miscarriage Of Justice

Sex In The Dark

Breaking The Bond

The Science Of Gender And Sex

Giving Blood: An Interview with Chris Bobel

The Female Condom Reloaded

Sexed Up: An Interview with Leonore Tiefer

I Choose My Choice: An Interview with Elizabeth Kissling

Love Your Vagina Dot Com

Not Just Another Choice: An Interview with Laura Wershler

Keep Talking: An Interview with Laura Eldridge

Courting

2010-02-05T13:50:00.000-08:00

Occasionally I like to take a look at how the lawsuits against Bayer Schering Pharma and their birth control pill Yaz are progressing. Today, when I made my usual Google trawl, I came across a piece regarding the enquiries the lawyers have been receiving from women who did not suffer from blood clots or their consequential strokes and heart problems, but experienced the anxiety and depression that I had for a good six months before I realized what was happening.

I had been wondering if the lawsuits would expand to take in the effect Yaz can have on mood, but figured that they might find it too difficult to present and defend. For a start a lawyer is going to have to defend the woman against attacks on her lifestyle, drinking habits, any family history of mental disorders. It would be a difficult fight, considering how there's almost always someone who will have had depression or something that can be labelled as a disorder and how everyone has a bunch of defamatory stories in their past.

The medical evidence for why Yaz causes such extreme changes in emotional state is there, but in order to use that evidence the case would likely have to include the argument that all birth control pills have the capacity to change a woman's mood dramatically and that although Yaz's particular make up does add a whole extra layer to the problem, the problem is still there potentially with all hormonal contraceptives. If Bayer Schering were to counter the case of a woman who has suffered mood changes by saying that all birth control pills have the capacity to do this, then they would be opening up the whole industry to a lot of questions. The woman cited in the piece, Sylvia, claims that Yaz caused her to have panic attacks, constant anxiety and difficulty controlling anger.

Of course she has to temper her complaint with the acknowledgement that her experience is not as 'serious' as a blood clot. This is understandable, but that level of anxiety can lose a person their relationship, their job and put much stress on their general health. The spectre of the Pill's ability to cause blood clots has long blotted out the other side effects. It is the one thing the doctor might have warned you about, and the source of the original concerns in the late 1960s about this newly released drug. When it comes to blood clots doctors and pharmaceutical company representatives can pull out all kinds of graphs to show how rarely they occur, how minimal the risk is and, most importantly, how improved the Pill is since its high estrogen ancestor Enovid. I assume they are having a little more of a struggle with this issue now that Yaz has upped the stakes. Also, I would think there's a possibility of more blood clot cases as more women in the US and Europe can be classed as overweight. But all in all, in comparison to the emotional side effects of the birth control pill, talking about blood clots must seem like a piece of cake.

To start talking about the emotional side effects of the Pill would not only reveal, in a court of law at least, the entrenched misogyny of the medical authorities understanding of women - bringing up all those ideas about how women are so suggestible and how they get depressed because their subconscious knows they can't have a baby when on the Pill or how women are just generally neurotic and hysterical and such is their natural state - but also shed a sharp light on how the pill actually works and the morality of shutting down women's reproductive systems and messing with their hormone cycles for a goal easily and safely met by other means.

The piece goes on to mention a woman who's daughter was put on Yaz and saw her 'entire personality' change. After taking the young woman to psychologists and counsellors she finally considered it might be the birth control pill. The mother says, 'We were told Yaz is the new 'miracle pill' - that it will make you lose weight, regulate your periods, clear up acne, you name it, it will fix it.' Bayer Schering made the mistake of advertising Yaz as a medication to treat anxiety, depression and tension, it marketed it as 'Beyond Birth Control' and as such made itself far more visible than other Pills on the market, far more popular and with much more to justify.

I am very glad that the horrible experiences of many women, including myself, on Yaz have caused this issue to be raised, but I am a little afraid that as Yaz has made itself stand out so far that young women will not think of it as the same as other birth control pills and will therefore not see that all birth control pills can impact badly on mood and well being. The problem with emphasizing the diuretic, potassium-sparing element of Yaz as the cause for the mood changes is that the only answer then given is to swap to another brand of Pill. Also the inevitable, and not completely false, emphasis on the Pill having a different effect on different women, allows the actual facts of the way it works to get brushed aside. All women should be aware that their emotional changes might be down to the Pill, not just those who take Yaz.

Since the blood clot cases came into the newspapers there is all kinds of talk on online forums about stopping Yaz, the withdrawal symptoms and how long these take to go away. Many of the women were completely seduced, as I was, by its skin-clearing, weight loss properties and struggle with the consequences of coming off it - often very painful acne and weight changes brought on by testosterone levels rising. It is worrying, although not surprising to someone who has felt just the same, to see women opting for clear skin and skinniness over emotional balance in their bids to stop taking Yaz. When you've been taught your female body needs medicating, and you can't help but find comfort in the control the Pill gives you over your body, it is hard, even when you feel like you're going crazy - or especially when you feel like you are going crazy - to know what is the best way forward for you.

We are, I think, often too keen to forgo our health. I guess we only think as much of ourselves as we told to, and the Pill is sanctified everywhere there is to look. It is also difficult in the current environment in which it is believed that we all suffer from stress and anxiety as part of modern life to distinguish whilst you are still on the Pill what is a normal reaction to life and what is a side effect. Once you come off the Pill you know for sure that there's a difference, but when you're on it, you constantly question every judgement as a consequence of feeling so detached from your self and the people, the world, around you. It is just as worrying that women get so little support from their doctors, who sadly seem to see the answer in more pills.

The Pill is not the appropriate way to deal with acne or heavy periods, it is not the moral or the compassionate way, but it is also not the appropriate way to approach birth control. It is a crude, primitive and aggressive medication that has absolutely no place in the lives of modern women. The Pill is not a cure-all, but it is also not just a way of preventing pregnancy. In doing that one task, it does a whole lot more to your body that is unhealthy and unwanted.

Missed Pills

2010-02-02T11:03:00.000-08:00

Today I came across an article about a study conducted at the University Of Massachusetts that found that women who take in a good amount of vitamin D through foods, sunlight and supplements experience a 70% decrease in PMS symptoms. The study apparently focussed on women who felt their PMS interfered significantly with their lives. The research is part of a wider study into how vitamin D effects women's mental health as a whole.

This interested me as I have mentioned before how the birth control pill creates vitamin deficiencies through its impact on the metabolic system. When taking the Pill the body is unable to absorb the necessary vitamins, so although eating healthily is never a bad thing, it won't alleviate the effects of the Pill on your general health whilst you are still taking it. However, as I've also said before, getting a good lot of vitamins in general can help you overcome the withdrawal problems when coming off the Pill.

The emotional changes provoked by Pill taking can be traced back in part to deficiency in vitamin D. In flattening out the monthly rise and fall of hormone levels, the Pill could be understood as decreasing the possibility of PMS - which is effectively created by changes in these levels before menstruation. But, as many of us know, the Pill can make you feel as though you are experiencing PMS all the time. In fact, that is how my nightmare with Yaz began, starting out with what I saw as very bad PMS - anxiety, sensitivity, rage - around the time before my withdrawal bleed, and then spreading out over the entire month until I felt like that every day to a rapidly worsening level. And of course, because the feelings are not PMS as you know it, in that it is not predictably timed, nor is it moored to any kind of reality, it is frightening and debilitating.

Of course, there are other factors involved - the flattening of the hormone levels in itself, the lowering of testosterone levels - but vitamin deficiency plays a part in mood changes, along with increasing fatigue and generally feeling less than vital and well. Yaz in particular is mentioned in the article as a drug often prescribed to combat PMDD - essentially understood as a severe level of PMS. The piece points out that increasing intake of vitamin D is better than taking this Pill, as there are no side effects.

I have long wondered if the current sun-phobia that keeps everyone in the shade and under hats and on sunlight watch constantly due on fear of skin cancer has some part in the increase of depression and depressive problems. It sometimes seems like people have understood sunbathing with caution to mean never going out in the sun at all.

The article also raised some questions for me. First of all, obviously in its wording, and in the study's emphasis, the suggestion is that PMS not only exists as a 'disorder' or an 'illness' that needs treatment, but also that it is generally a negative experience that women do not want to have to undergo. Previously I have written about the invention of PMS as such, and how it came about at a useful time when it was necessary that women's abilities be undermined and women be sent into their homes to remain as homemakers and mothers, giving the post-world war two work back to the returning soldiers.

I have experienced what I would consider to be PMS I suppose, but rather than interfering with my life it appears to give me clarity on situations, and basically make me less tolerant of those situations that I feel are injust somehow. I just lose my patience with towing the line and keeping quiet and making compromises. I do get more angry than I normally would, and can see now into my fifth natural cycle off the Pill, that I get more intolerant of people around me. I can also see now that although my Yaz experience seemed like PMS spreading out over the whole month how I felt bear very little relation to real PMS which when it comes on, predictably, is actually pretty enlightening.

The issue here I guess is that there are women who experience extreme tension, anxiety and depression before their period - and I mean real period, not the fake Pill-induced kind - and they need to be acknowledged. There are also women who experience very painful periods who also need to be acknowledged. The Pill does not help with either of these problems however, but only masks the symptoms. It is therefore good to here that research is being done into possible treatments as alternatives to taking the Pill.

Increasing your vitamin D intake isn't going to hurt either way, and according to the study you'll still have 30% of your PMS to deal with. For ten years I was happily giving up my entire natural cycle and replacing it with the synthetic hormones of the Pill - now nearly five months off the Pill I have issues with even giving up the agitation and anger that comes just before my period. Despite my initial reservations, as I said my periods as a teenager were painful, heavy and pretty difficult, my cycle at 27 years old is a whole other experience.

As the study I cited found, young women's cycles take a few years to settle and regulate out. Prescribing the Pill to girls at fourteen is preventing them from finding this out, amongst of course a whole host of other things the Pill prevents. Perhaps if women were allowed to know more about their cycle and how their hormone levels change then PMS would be less intolerable in general, it would not be something happening to them, but something their body is doing that is natural, and possibly useful. I am not belittling any woman's experience, I am only championing the fact that the Pill really isn't the answer to horrid PMS or heavy periods and there are other options for dealing with this that should be tried out, or at least given a platform, rather than sunk beneath the promotion of the Pill as a cure-all.

I watched Diana Fabianova's documentary The Moon Inside You yesterday. It raised some subjects that I have not yet tackled here. I am always reluctant to come across as too hippy-ish when talking about women's natural cycles, periods and the like. Mostly because I am not at all hippy-ish and usually feel quite alienated by that sort of discussion. By which I mean the kind of discussion in which periods are celebrated and PMS is about female intuition and all women are connected to nature and we are special...And yes I completely acknowledge the reasons for why I may feel alienated by that talk, being that it is a sidelined perspective, likely deliberately undermined publicly and in fact called 'hippy-ish' in an effort to undermine its meaning. And yes it probably has a lot to do with how I see myself as a woman and how I understand being female, and how all that is certainly effected by living in a society that is hostile to femininity and female-ness. However, I also know that most twenty-something year old women feel the same and so I like to avoid going to far down that path.

That said, the documentary brought up how the social silence about periods - it was mostly about how women see their periods, and how society sees women menstruating - effectively isolates women from each other. We have all heard that anecdotal story about how women in the same college dorm, or the same shared house will eventually synchronize their cycles to have their periods at the same time. I have no idea if this is right, despite having attended an all girls' school for my whole teenage life, and a girls' college for one year, but even if it isn't there's something to be said for how the biological experience should make us feel some kind of unity. It is a shared experience, and it is something women do that men don't.

If we talked more openly about our experiences, rather than just placing them under banners such as PMS or using euphemisms, then we might find the natural cycle more interesting, feel more connected to our bodies and therefore our selves and our female-ness. Perhaps then we might feel more confident about being women and struggle less with the idea. But if this were to happen then it could be threatening to the status quo, and for it to happen we would need outside approval - like social acceptance. Or would we? Maybe women could come to the point without having to wait for society to decide that natural cycles are interesting, or even at least healthy, and that periods are not disgusting or dangerous. Perhaps women could do so by having a mass ditching of the Pill for good.

The documentary also pointed out that with each new cycle there's a possibility for reinvention inherent in the change. If you want to see it that way, you can, like the energy women can get after their period, which for some is a time of reflection, along with the PMS and its intolerance, could be seen as an opportunity for getting stuff done, and action and dynamism. It could be seen as a time to start afresh, with a changed perspective, or an altered perspective on what you want to do, need, and backed up the ability to make that happen. I can certainly relate to the change in energy, and the heightened level of concentration and clear thinking also.

This idea of change is the opposite of the status quo. By the status quo I mean the way things are in the world today - how society is structured, how women are treated, how women see themselves. The structure of how the world is necessitates for its perpetuation that we do not see the need for change, or at least the changes we see the need for are minimal (or rearranging the deck chairs on the Titanic as I like to say). Politicians may talk about change and gear people up with excitement about it, but real change is hard to come by, and when it comes down to it, most of the changes are poor substitutes for the real potential that exists. If things get to stay as they are, the people who are rich get to stay rich, the people who are poor get to stay poor and so on.

Essentially we could see women's natural cycle and that sense of flow and change that comes with it as threatening to the way things are. And if women were to become properly aware of that sense of change it could be even more threatening. If all the women on the Pill came off it and started to find their cycle interesting then perhaps that would be seen as a problem.

Aside that is from all the other problems it would cause - like all the money the pharmaceutical industry would lose. Women not on the Pill would be released from the depressive impact on their mood and well being, firstly. Then they would experience their natural cycle and maybe talk about it and maybe like it, and then they could see their reproductive abilities differently and start questioning how women's role in society has been created and the skewing of the understanding of these abilities. If coming off the Pill can be life-changing, as one commenter wrote here, and as I would agree, what does that mean when lots of women decide to stop?

The documentary went on to discuss the idea of collective consciousness as related to women's natural cycles. Consumerism is helped by isolating people - that's pretty basic analysis, but it's true. Isolated people buy more stuff. The Pill shuts down a collective experience. Collective experiences, and the collecting together of people, is essential to any kind of rebellion or change - in order in a sense for anything to change.

One interviewee in the documentary used very un-hippy-ish language to talk about the promotion of the Pill. He stated that the Pill was effectively society's way (and I really don't see it as men's way, because I think the economy and the structure although dominated by men, is not their 'fault' as such) of reprogramming women to fit into its established structure. The natural cycle is a source of change, flow, collective experience - it is connected to the natural world, to women's power in reproduction - and so society did not want to incorporate it, instead it had to be shut down, cancelled out, forgotten, sunk.

The interviewee also said that it was implemented in order to make women 'more like men' - obviously not quite how it works as men still get to have all kinds of natural hormone changes - but I can see where the idea is going. The masculine was acceptable, whereas the feminine was only faulty masculinity, or a disease. Masculinity and the appropriated traits of this, were understood as foundational to society - although it could be argued that the structure is based on inhuman (not male or female) elements. Either way, it initially needed to keep men dominant over women. Natural cycles were a threat to this on all kinds of levels. The Pill helped women enter the male workplace, and be accepted into the male world, but in disconnecting women from themselves, their bodies and each other, the Pill helped perpetuate the male-dominated social structure, by preventing awareness of potential for change and other ways of living, as well as prevention of awareness between women of themselves as a race.

I came across an article in the San Jose State University publication, The Spartan Daily, entitled 'Skipping the Contraceptive Pill: Rebel With Michelle.' I like the way the title turns around all the paranoia about women missing pills in a month which is inspiring this drive to get those women on to long-acting hormonal methods like the hormonal IUD, injection and implant. And I like the way stopping taking the Pill is being discussed as 'rebellion' as that is what it is in that Pill-taking has become socially encouraged, with women seeing the Pill as their only option and the only sensible, responsible contraceptive method to use. There is a situation to rebel against, an oppressive force that in stopping the Pill women are fighting against.

So, the article is written by Michelle Gachet who claims that the Pill turned her into 'an emotional psycho' as a result of the 'hormonal game' the Pill was playing with her body. Her decision to come off the Pill was influenced by her reading about the development of the male Pill. She decided she didn't want to be the 'only one in the relationship with the wacky crying episodes.' Michelle got frustrated with the fact that she lives in a world in which men get to ask, 'did you remember to take your Pill today?' as though it were normal, natural, required.

I am unsure of her feelings only in that I would in no way encourage the development of a male Pill and have no desire for men to experience the side effects such a drug would certainly hold. In my last post I suggested the suppression of libido that would occur is interesting to consider on a philosophical level - in terms of what such an impact en masse might bring about - but I would not, even in my anger at how women are pushed the female Pill - want the male Pill to be released on to the market. I do encourage discussion of the development of the male Pill, only as it encourages reassessment and consideration of how the Pill works on women's bodies and why the way it works, and what it is, is acceptable.

Michelle discovered the potential side effects by searching the Internet. I guess when you live in a country that charges an uninsured person around $200 just to sit in the doctor's office, let alone the additions for actually asking questions, the Internet is a great place to exchange information. I do encourage anyone to look at the boards on the medications.com and askapatient.com sites for comments about Yaz - it is the most complained about drug on the internet, a fact that only goes to support my view that open discussion of the reality of Pill-taking is systematically suppressed.

Skipping The Pill: Rebel With Michelle

Definition

2010-01-22T10:53:00.000-08:00

The BBC aired a documentary in the Horizon series entitled Pill Poppers last week. The entire thing is available here on YouTube:

Pill Poppers

Although it only briefly discussed the contraceptive pill, what was said about our relationship to pills in general and the changing motivations of the pill-making companies was very pertinent. The programme starts off with different people sitting down on a couch and presenting the medicines they take on the table in front of them. This was immediately interesting to me as I do think women have a complex relationship with the birth control pill, and to sort of personalize drugs in this way, and show what a significant role they play in people's lives really emphasizes that idea. The documentary went as far as to say that, 'Pills define who we are.' You might recall I wrote a post about the similarities between taking the birth control pill and being a smoker a while back. I said how women who take the birth control pill don't consider themselves pill-takers, not like someone who smokes might these days consider themselves a smoker, and that this shows a lack of awareness of the pill as a drug and a lack of seriousness in its prescription and usage.

One woman had her birth control pills in front of her on the table and began discussing why she took them and one of her comments was, 'I read the list of side effects in the leaflet and I had them all.' I guess, firstly, it was different to see the birth control pill discussed alongside painkillers, anti-depressants and drugs to stop you having a heart attack. Secondly, it was interesting to consider pills as part of a person's personality and lifestyle. I have been thinking a lot more about the pill and addiction lately, and I suppose one of the definitions of an addiction would be if the substance you couldn't stop taking was effecting you, your character, responses or outlook. If you were taking the substance for so long it became inextricably linked to who you are.

Now, the pill can actually change your personality in that it can cause severe mood changes, anxiety and depression, and change how you see other people, events, the world around you. So there's a definite link. But taking the pill, and accepting the pill, gives you a certain outlook on your body, self and your place in society. It does come to define who you are as a woman, as a young woman. It imposes the definitions of femininity on to you, as well as restricting your understanding of femininity. If you take the pill and happily shut down your ovaries and uterus, your natural monthly cycle you are as a by product of this action accepting certain ideas about women and their capabilities and their positioning. I've said before that taking the pill, if looked at in a historical context, appears like a rejection of femininity, or femaleness.

I dislike any suggestion that women are somehow masochistic, and I can see how that might seem part of an addiction theory, but just as with plastic surgery, or Botox, or waxing, women do things that hurt them all the time, not because they particularly want to, but not also because they are passive victims of other people's desires. It's more that we live in an environment that requires these things, and as living human beings we are responsive to that environment. Like a plant photosynthesising perhaps. It's socially constructed, but in the same way a bank is understood to be a bank and a school a school. It's ingrained. And because it is so entwined in history and culture, we feel a certain comfort in the ritual-like aspect. I suppose you could see taking the pill every day as ritualistic. Every time you pop one in your mouth it's reaffirming a whole mess of ideas about women which we have all internalised.

The documentary also talked briefly about the possibility of a male contraceptive pill. One of the doctors researching into this is interviewed and he explains how they need to 'put the testes to sleep' to stop sperm production. The narrator of the programme notes that this will be 'tinkering at the heart of what makes a man a man.'

Most interestingly, the doctor argues that people are wary of this, and that if the female birth control pill was developed and invented today from scratch, it would not be welcomed. Odd, in a way, considering, every day the pill is presented anew to young women and they keep taking it, in new and modern forms of reinvention - the present day pill is not the same as the one launched in 1960. Made me recall that statement a doctor made in the press about hormone replacement therapy, that it didn't have a place 'in modern medicine.' Also, the push is now for the not so much new as rebranded injection, implant and hormonal IUS and these are being presented to women as the latest thing in contraception.

I think the male pill still hasn't arrived because the pharmaceutical companies are not sure there's a market for it. They think men won't accept the side effects, which are likely to include lowered libido. There have been scare stories in the media about the pill - in the late 1960s when the high level of estrogen was causing blood clots and strokes, and now and then throughout the last few decades, and despite all this women keep taking it. Yes, most of these scare stories are underpinned with a statement that the pill is 'the most researched and safest medication on the market' - an assertion full of holes. The claim made by the doctor in the documentary does suggest that a big part of the pill's allure is in its cultural mythology and social integration.

The documentary narrator then goes on to say, 'A man without sperm. No more radical than what millions of women endure.' This is great to hear, and actually most of what is said previously about the potential male contraceptive pill is with this statement linked to what women undergo taking the female pill. Instead of emasculation, women are subject to de-feminisation. But whereas emasculation seems like such a potent word, full of implications, the opposite for women doesn't hold as much concern. One of the points made is that for a man to remain physically a man they would need to add sex hormones after they've taken away their production by the testes, in order for men to still look like men. Women on the pill of course still appear as women - in fact the effect of lowering testosterone levels arguably makes women closer to the social feminine ideal. That women still look womanly does play a part in the pushing of the pill. That they don't necessarily feel womanly, feminine, or sexual, is what we've been discussing here. That this side of the pill has not been considered in the last 60 years is illustrative of deliberate ignorance.

The doctor in the documentary suggests that if the male pill was released, and more importantly marketed well, it could bring about a second Sexual Revolution such as is understood to have happened in the 1960s. I have written before about how the supposed sexual revolution was not down to the pill alone, but a combination of economic and social factors. I had a man, David, comment on a previous post with his theory of what would happen if the male pill was released. Much of his comment was made up of disgustingly misogynistic remarks stating that the pill allowed women to use sex as a 'reward' and therefore manipulate men with this power (although I have to say, David may not have realized, this suggestion proposes that men are basically dogs, or toddler-like in their mentality, which makes me wonder about their supposed 'right' to rule over women). There is much wrong, in logic and moral terms, with David's statements - he believes rape victims get an easy time in court and are not required to have 'hard evidence' - he also believes the male sex drive to be 'a powerful force' which he doesn't seem to realise will be entirely quashed by the male pill (possibly the real source of this new 'freedom' for men David hankers after will be freedom from their tyrannical sex drive, if they so want it, and the ability to think about other subjects than sex, if they so want to) - but he is quite adamant about their being a revolution coming. Unfortunately for us David believes this revolution will bring about the subjugation of women 'as exploited work units with no rights' - a conclusion he puts down to, in part, the rising levels of unemployment for young men.

I had been hoping the male pill would bring about a reappraisal of the female pill and general enlightenment as to the inhumanity of having any person, male or female, shut down their hormone cycle. I was also hoping that a backlash against the pill would work out well for women, but have expressed concerns that with the headlines shouting that more women are in the workplace than ever before, we are heading for some kind of chastisement for all our power-hungry doings. David is hopefully representative of a minority, but he does show how there are forces that will always ensure women are understood to be bringing about the downfall of civilisation. He is the extreme but his ideas are present, in diluted form, in the mainstream. I think Freud wrote about how female sexuality had to be controlled for civilisation to develop. Whether it's the 'mad feminists' or poor Britney Spears, we don't win, and we do need to brace ourselves for something of a bumpy ride if we want to get society to reassess medicating millions of us.

The documentary ended talking about a drug that has been developed that can be given to men over 50 as a preventative to heart disease and heart attacks. Here the programme proposed the direction in which the pharmaceutical industry is working. The drive is to create drugs that don't treat illnesses, but treat risk factors. One of the doctor's interviewed expressed concerns about how 'A drug company's dream would be a pill not designed for sick people, but for everyone. A pill that's not good for you, but good for everybody, and you are a part of everybody.' Hmm. I don't think this is a recent development in the industry. The birth control pill does not treat an illness, it does in fact treat what is seen as a 'risk factor' - a woman's fertility is a risk factor to pregnancy it could be said, and menstruation is often reported as a risk factor to many health problems - the pill isn't good for an individual woman, it is promoted as being good for everybody - with no account of each woman's delicate natural system taken into account and complete emphasis on the pill's use for population control. And population control is supposed to be good for the health of all, so an individual woman is an easy sacrifice in the equation. The last scenes of the documentary were supposed to express a foreboding sense of the future, but we are already experiencing exactly what we are supposed to be fearing.

Wake up

2010-01-13T09:39:00.000-08:00

Sleep Challenge - Glamour

Sleep Challenge - Huffington Post

Cindi Lieve of Glamour magazine and Arianna Huffington of the Huffington Post have this week launched the Sleep Challenge. They're saying that as women are far more sleep-deprived than men, that sleep has become a 'feminist issue' and needs dealing with via an en masse New Year's Resolution for all women to sleep a full eight hours a day. Reading their introductory pieces to this idea, I was struck firstly by how this reaction from two powerful women has come out of the build up over the last six months or so of articles about sleep deprivation which I had noted and wondered about, and secondly how the language they use to describe the effect of sleep deprivation on individual women, and then consequently on women as a group, is very similar to the sort of thing I have been saying here about the impact of the birth control pill. See, for example, the following statements:

"A nation of sleepy women is even less capable of greatness. Consider the fact that sleep deprivation is a strategy many cults are fond of: They force prospective members to stay awake for extended periods, up for all hours because doing so physically alters their subjects' decision-making ability and makes them more open to persuasion. Ladies, the choice is ours. Do we want to be empowered women taking charge of our lives -- or do we want to be cult members, dragging ourselves around like zombies and going along with everyone else's crummy ideas?"

"Women have achieved so much already. Think what we can do if we're not tired!"

The issue is couched as such: our culture of productivity and competition in the workplace has eroded our natural sleep cycles - which should be, according to the experts, between seven and eight hours in length a day. Women feel the need to prove themselves more so than men, and therefore work longer hours, work at home and take on more tasks. They also often have to take care of the larger part of the domestic duties - cleaning the house, as well as putting in the most effort with their children. Essentially in order to take on the challenge of their acceptance by men, the potential for equal status and success, women have sacrificed their sleep cycles. All sounding rather familiar right?

I have actually previously made comparisons between the natural ovulation cycle and the sleep cycle. The authors of 'The Pill: Are You Sure It's For You?' have spoken to me about, and written about, the growing interest in maintaining the healthy sleep cycle against the demands of life and society and how this connects to the also growing interest in maintaining the healthy ovulation cycle and ditching hormonal contraceptives. Any interest in how women's bodies work and how the disruption of these workings could cause problems will be helpful in opening up discussion about the Pill. Sleep is, of course, a less contentious issue in some ways. But the way this Sleep Challenge is being addressed is interesting - it is argued that the more women sleep the more they can achieve within the hours they are awake, and the better off we all be for it, as then we could contribute more, be more inventive and creative and progress society as a whole.

Without being totally direct, these two women are advocating some drastic shifts in how our lives are structured - changes not only in how jobs and work patterns are organised, but also how family and home life is shared. Really, for eight hours a night to be possible, there needs to be a better balance of responsibilities between men and women so that women are not doing their job and then coming home to take up the entirety of their second job, looking after the house and the children. If women are taking themselves off to bed, regardless of their left-over duties, the protests of their husbands and children or the needs of their job, it is a kind of pacifist protest. There's something in there similar to how upper class Victorian women when faced with their social duties, chores and other boring entertainments would become ill and need bed rest for months, years even. Barbara Ehrenreich, amongst others, has spoken of the bed rest movement of that era as not only symptomatic of women's oppression, but also an act of rebellion against the structure and substance of their lives.

Of course, the Sleep Challenge is only going to speak to women who, like the editors of these publications, are generally well-off, have job security and have supportive husbands, relatives - or perhaps no children at all and a cleaner who comes in twice a week. Women who are single mothers working up to three jobs - I'm certainly not creating this character for dramatic effect as I see and speak with such women every day - are not depriving themselves of sleep by staying up speaking with the features editor about next month's fashion shoot focusing on transparents, or checking their Blackberries for the latest news. They are up working at an all-night diner, or cleaning offices first thing in the morning, or having worked for twelve hours that day trying to have a little social life and fun by meeting their friends. I'm not saying that editors of magazines shouldn't be getting sleep, or that what they are doing when they are not sleeping at night is unimportant, or that they shouldn't indeed be encouraging women to sleep more, if possible. They do make reference to a wider change that is needed here, to the suffering of women as a whole under the current social conditions. And I know this is America where even if you are a single mother working three jobs you are supposed to be constantly 'aspiring' (rather than just plain hoping) to one day have a cleaner and a nanny and a nice editing job. I am absolutely glad this issue is being discussed, as I say, it can only help with my own birth control pill challenge, I just have to bring this stuff up because, well, they aren't.

Also, we're not just talking single mothers with three jobs, we are in the middle of a recession here in which three jobs are being made one and palmed off on one young woman after another for little pay in order to save the company money. If you want to keep your job, there's a good chance you do need to stay late, come in early and work at home, as if you don't there'll always be someone else who will instead. I have worked in media jobs, and media jobs alone, and I have always felt the pressure to do above and beyond my daily eight hours as I am well aware of the long line of people willing to take my place for less money. And when I've worked for free, that's when I have particularly felt the pressure to stay on and work as hard as physically possible to please - in one position under the same roof as Glamour magazine I lost two stone doing just that. I am currently fitting in writing this blog around a tight schedule of minimum wage work, and in fact I should really be at that minimum wage job right now because I do need the money, but am bargaining for some time to achieve something more significant to me.

I am intrigued by the health problems set out as caused by sleep deprivation and started doing some research into the background of these problems, as in what was happening in the body when it isn't getting enough rest that makes you sick. I discovered there's a whole lot going on to do with hormone production disruption. An article here discusses the effect on hormones and metabolism, which are two of the main areas of impact of the birth control pill also:

http://cme.medscape.com/viewarticle/502825

This is a whole other medical, scientific kettle of fish, but this article at least sums up the connections, and shows that when bells started ringing with this Sleep Challenge, they were right to - there are many comparisons to the effect the Pill has on our bodies. I guess I don't need to wade into the science to realise the body has cycles that keep everything working at its optimum level and when these are disrupted continuously over long periods of time the body will suffer. I love to see how every third point made in the Sleep Challenge blogs is about how getting more sleep can make you more attractive. As in, you eat less junk, you will lose more weight, you will look better. They do mention interior health benefits, but the impact of these interior health benefits on your skin and body seems to be more discussed than anything. I don't mean to be harsh here, it's just funny to see that, and as someone who reads women's magazines, I get why they're doing that and I kind of buy it, too.

It's been four months since I came off the Pill now, and I honestly feel great. I don't necessarily look that hot though, as I have mentioned before it feels a little like being a teenager again with bad skin and hair and at this point I am wondering if it will settle down sometime soon. I don't want to eat as much however, and my hypoglaecemic-like blood sugar drops have evened out helping me to eat healthier. Seeing as I have not been de-toxing myself in a way that would be recommended when coming off a drug after ten years - I'm still drinking alcohol, eating junk and not exercising enough - I am pleased to see how I have progressed. And I think by changing very little in my life, apart from stopping the Pill, I have been able to see how the Pill was really, truly effecting me. If I feel better in ways now, I can be pretty certain it is because I am not on the Pill.

I have argued here that the Pill impairs women's judgement, decision-making, concentration, creativity, energy and so on, just as Arianna argues about sleep deprivation. I have also explained my thoughts on how the Pill being taken by many women, for decades could be keeping us down - letting us go along with other people's 'crummy ideas' because we are too weakened by it's insidious effect on our bodies to have the strength to do anything else. I have suggested that the Pill was taken on enthusiastically as a sacrifice that would allow us to be fully indoctrinated into the man's workplace under the man-made rules. Also, I've written about how suppressing our ovulation cycles could be holding us back, that the Pill is a form of oppression we have gleefully accepted in a cruel bargain. So, yes, lots of correlations here.

Arianna doesn't go as far as having a sleep deprivation conspiracy, or suggesting that the problem is the result of anything other than the pressure on women to out-work men and prove themselves and their equal status. Basically, she doesn't say, as I might have been inclined to, that a sleep deprived people are far easier to govern than a wide-awake people, and far easier to manipulate, scare and goad. Forget about what they do in cults and for torture techniques, sleep deprivation could be seen as a useful tool for keeping us all in check in our day to day lives. An awake woman might be more creative, productive, inventive and critical, but is that what the economy really needs? In one way yes, in a ton of other ways, absolutely not.

Balancing act

2010-01-02T17:34:00.000-08:00

Happy New Year - according to the Back Up Your Birth Control campaign, the night of New Year's Eve is renowned as a time of contraceptive mistakes, broken condoms and missed pills. Or 'birth control oops' as they like to call it. The campaign encouraged young women to send their friends a 'funny morning after message' through their web page, reminding them of the availability of the emergency contraceptive pill in case they had indeed had a birth control oops.

www.dontdroptheball.org

The title of this project is Don't Drop The Ball, which I am assuming is a reference to the ball drop in Times Square on New Year's Eve, but comes across as some sort of an affront. Like, once women have had their fun, they mustn't forget it is totally their responsibility to make sure that no baby comes of it all. It kind of suggests in a patronising way that a woman can fail a man by not taking a massive dose of synthetic hormones to prevent her body getting pregnant. Like if she did get pregnant, it would be all her fault for being irresponsible.

It even seems to suggest young women should be taking the emergency contraceptive pill after casual sex even if they are on the birth control pill or used a condom, therefore implying that they were probably too drunk to remember if they did take their pill or use a condom and generally not to be trusted. Rather brilliant marketing on the part of the makers of emergency contraceptive pills. We have been convinced we need to use the pill to 'back up' perfectly safe condoms and now we need to use the emergency pill to 'back up' the every day pill and the condoms.

It's so weird to see this kind of fun, self-consciously stylised advert for a powerful medication with the message that young women should be taking this drug on the prompting of a 'funny' text from a friend. Women's bodies are so frequently treated with such a casual, flippant attitude.

The implication is that young women really can not be trusted to not get pregnant, that they can not be trusted with their dangerous, fertile bodies. There is no consideration of the actual workings of a woman's body, and the probability that she will get pregnant that particular night, because she will be fertile and able to get pregnant that night. This essentially scare-mongering, paranoia-inducing campaign is based on the false information that is constantly and consistently promoted to keep women in check, and keep us taking expensive medications - falsities like women are constantly ready and waiting for pregnancy, that their hormone levels don't change throughout the month, that there isn't an ovulation point directly linked to fertility - in all, basically, that women either get pregnant or have periods and it's all very simple, basic stuff.

The Guardian newspaper did a photo series recently on the most talked about people of the year or something, and under a picture of Britney Spears was the comment, 'Spears became central to one of the decade’s major narratives: the depiction of young women as insensible, incompetent, insatiable, intoxicated.' For a while now I've wanted to write an article, a blog, something on the representation of young, famous women in the media. I hadn't thought the topic might link in with my writing on the birth control pill, but I guess it does.

All four of there adjectives back up most of the discussion of the birth control pill, and even more so the long acting methods of contraception like the injection and implant - it's not discussed openly for the most part, but it is definitely implied that the control of women's bodies must be in the hands of doctors and drugs, otherwise they will likely cause the downfall of civilisation with their irresponsible, baby-making ways.

The NHS campaign I spoke of in the last post, the one to get the pill given to women over-the-counter at pharmacies, definitely suggested that in missing pills, not using condoms and asking for emergency contraception women were showing themselves to be out of control and suspicious. They say it's about choosing the right contraceptive method for your 'lifestyle' - but we all know what a cover-up the word 'lifestyle' can be, and how it can be used condescendingly to suggest distaste at how someone lives their life. If you have a lifestyle in which you can't remember to take a pill every day then you will be seen as a loose woman, a slut and persuaded to get a shot once every three months instead that will not only wipe out your fertility but also act as a chemical castrator and stop you wanting sex ever, at all.

I recently finished Susan Rako's No More Periods: The Risks Of Menstrual Suppression in which she questions the oft repeated assumption that there is no good medical reason for menstruation. Dr Rako argues that aside from those women who are epileptic or have migraines related to their monthly cycle, and those who suffer from severe endometriosis, the birth control pill is detrimental to your health. She asserts very persuasively and with reference to tons of research that a woman's natural cycle ensures her blood pressure is lowered for half the month, and that she loses excess iron stored in the body which reduces the risk of heart attacks and strokes considerably. Excess iron is only secreted through menstruation which does not occur when women take the pill, thus putting them in danger of cardio-vascular problems. Cervical cancer is also mentioned, with Dr Rako arguing that the pill is a co-carcinogen with the HPV virus in causing this. According to her studies women are at higher risk of the cancer developing when taking the pill, plus they are less likely to use barrier methods and protect themselves from getting the virus.

Most interestingly, Dr Rako cites the 1964 Declaration of Helsinki which assured the interests of the individual be put before those of society. She cites this before discussing the preliminary experimentation that formed the discovery of the contraceptive effects of the Depo Provera injection. Pertinently she remarks on studies that show that the GPs of upper income patients show far more negative attitudes towards the injection than those serving lower income women. In my last post I discussed the piloting of the NHS scheme, with prescription-less pills and pushing of the injection, in the poorer areas of London.

Dr Rako also makes the interesting statement that there is no such thing as 'side effects' and all the effects of a drug on the person taking that drug are simply its effects. Some of the major uses of some major drugs were only developed because of the discovery of a 'side effect' in trials for another use. If we stop calling the effects of the birth control pill on women's bodies 'side effects' a much brighter light is thrown on the discussion.

A recent press release from the American College of Obstetricians and Gynecologists was entitled 'Hormonal Contraceptives Offer Benefits Beyond Pregnancy Prevention.' Women are often sold the birth control pill on the basis of its acne-clearing, period-stopping abilities and yet when we want to discuss the negative effects, it is pregnancy prevention that is said to trump any and all complaints. The Yasmin advertising campaign goes under the banner 'Beyond Birth Control' and yet when the knock-on effects of its unique make-up came under scrutiny it was back to being just plain birth control.

Counterpoint

2009-12-14T11:57:00.000-08:00

In the summer of this year, I was researching for a feature for Easy Living magazine on the potential side effects of the birth control pill and when searching for a news hook for the piece, I found out about the preparation of a NHS scheme which would allow oral contraceptives to be distributed from pharmacies without a prescription. At that time, all of the doctors I interviewed expressed concerns about this development, even the most conservative GPs who stubbornly dismissed my concerns about side effects.

Then last week it hit British newspapers that this scheme had recently launched in the areas of London that have the highest rates of teenage pregnancy. Bold, bright posters in the style of laundry soap adverts exclaiming that the Pill is now available without prescription are up in pharmacy windows of Lambeth and Southwark. According to the news reports the pharmacists involved were given three weeks of training in order to provide consultations for young women looking to start taking oral contraceptives or wanting to move from the Pill to long acting methods like the injection, the implant or the hormonal IUS. The implication was also there that if young women came to the pharmacy for the emergency contraceptive pill then their consultation would involve the suggestion that they start on the Pill or a long-acting method.

The British government can't seem to figure out how to handle their teenage pregnancy problem. They are looking for a quick, effective, wide-reaching fix that doesn't cost much - certainly not as much as working with individual teenage girls to discuss their attitudes towards relationships and definitely not as much as providing holistic sex education that covers both the technical and emotional aspects. The NHS as a countrywide health service can be brilliant at organizing awareness campaigns - such as their quit smoking scheme - but providing the Pill without prescription is a step in the wrong direction.

Aside from the fact that this proposal will, without a doubt, devalue the Pill as a drug, a medication, and thus make it appear harmless, and therefore keep women ignorant of its potential impact on their health and wellbeing and prevent them from seeing the signs of side effects - any 'consultations' provided by pharmacists are very unlikely to be comprehensive or cautious. We already know how most doctors deal with doling out the Pill - many simply do not tell the truth about how it works, and do not talk about the potential problems it might cause, particularly in terms of mood and emotions.

The pharmacists have probably been told to check the teenagers weight and blood pressure on their first visit - but what about scheduling follow up appointments? Will the teenage girl go back every six months and check in with the pharmacist for another consultation? How many packets of the Pill will they be given to start? It can be assumed busy pharmacies aren't going to want to have a constant round of check ups and would be more inclined to hand out Pills literally over-the-counter after an initial talk. This goes against even the loose policies presently in place for obtaining prescriptions. Women must return to their GP every three or six months to check for problems such as the increased blood pressure, migraines or breathing difficulties that might suggest a blood clot formation.

Most women get the Pill from their GP, but often family planning clinics are much more interested, at least in the UK, in the side effects a woman might suffer from on different brands. This new scheme appears to stem from the root idea that teenage girls are secretive about taking the Pill and therefore want to avoid their family GP. The spokespeople for the scheme have said teenagers go into, say, the Boots pharmacy to buy cosmetics, so they can pick up the Pill easily and inconspicuously. It seems very doubtful that teenage girls really have this problem with people knowing they are on the Pill. Would these consultations, like those available at a family planning clinic, involve discussion of condoms and the necessity that they are used for casual sex at all times? If teenage girls are using condoms properly then they wouldn't need to take the Pill, and they definitely need to use condoms to prevent getting or passing on STIs.

President Obama is putting money into a research project to investigate why men don't like using condoms and how this problem might be helped. He is backing education on the proper use of condoms, and research on the design and marketing issues that stop men using them as often as they should. This seems like an excellent move. Condoms are very effective when used correctly and diligently and even more effective if used with spermicide. Studies have shown far lower rates of unwanted pregnancy amongst young women using condoms and spermicide than those using the Pill alone. Teenage girls could also be encouraged to buy condoms with their cosmetics at Boots pharmacy. Many young women don't use condoms because they don't want to bring the subject up, and neither does the NHS it appears.

Maybe money should also be put into getting the one-size-fits-all diaphragms now designed and ready through FDA approval and out on the market as soon as possible. Then money could be put into educating women about this original, truly liberating contraceptive method. Then teenagers could buy diaphragms with their cosmetics.

The pill encourages the kind of thinking about sex and attitude towards relationships that likely causes the UK’s higher rates of teenage pregnancy. Keeping contraception invisible, unobtrusive and solely the girl’s responsibility encourages a skewed perspective on sex and relationships. This outlook separates the idea of sex from reproduction - and of course sex should not have to lead to reproduction - but it also completely ignores how a woman's body works.

I'm not a moralist, or a right wing Christian, but the action of having to stop for a moment and put a diaphragm in or stop and put a condom on could actually be helpful in more ways than just the preventing of pregnancy and the transmission of STIs. This pause makes a person consider the partnership, the other person, the situation and their feelings about that. It puts sex, however casual, into a context. Actively promoting a contraception - the Pill - that perpetuates a silence about sex, our bodies and our relationships is not the solution.

Barrier contraceptive methods involve conversation, discussion and pause. Where do teenage boys factor in this NHS scheme? Perhaps the possibility of a resulting pregnancy is one thing that stops some teenage unprotected sex from happening. But if all the girls in Lambeth are on the Pill, then perhaps there will be more unprotected sex happening, not less, and therefore more STIs spreading. These STIs might cause a few hundred teenage girls to become infertile - but perhaps that is what the British government would like. The creation of the Pill has foundations in eugenics studies.

The part of the scheme concerning moving women from the Pill to the injection and the implant is obviously part of the general British government drive to get women on to long-acting methods. These methods will further divorce thinking about sex from any reality, and promote silence and ignorance. They aren't piloting this scheme in the affluent areas of Knightsbridge or Hampstead in London. We can assume there is a link being made between poverty and teenage pregnancy rates. If we can assume this, then the scheme smacks of the crusade to stop the 'wrong' kinds of people having children.

There is research that shows how important it is to let young women's menstrual cycles mature and settle - a process which can take four or so years. The Pill will be available to teenagers that are sixteen years-old and up. These girls are developing a sense of self and sexuality and the Pill will distort that experience dramatically for some of them. Who is this scheme for?

Weight, blood pressure or genetic predispositions will probably not be discussed properly, so there will almost certainly be an increased risk of physical problems developing. The mood changing effects of the Pill will not be discussed in the pharmacy consultation room. If the young women experience low libido as a result, that will be considered a triumph! As it was handed to them at the local Boots along with their lip gloss what's the likelihood that the teenagers will consider the Pill might be the cause behind their panic attacks, their suicidal thoughts or even their severe headaches?

President Obama's decision is more progressive. Much is said about the American government's unsupportive attitude towards the birth control pill - such as the Pill not being covered by medical insurers and abstinence-only sex education. Perhaps somehow out of all that religious, moralist, conservative talk of the last Presidency around the issues of contraception, and the subsequent suspicion of the Pill, there has finally formed something useful and sensible. The British government appears wholesale fanatical about the Pill in comparison. Their attitude holds just as much ignorance, just as strong an agenda and just as little respect for women as the Religious Right has displayed at its worst.

Building up barriers

2009-12-07T20:38:00.000-08:00

http://www.rhrealitycheck.org/blog/2009/12/02/love-glove-ten-great-reasons-use-condoms-you-might-not-have-heard-yet

Just finished reading this brilliant article on the Reproductive Health Reality Check website, Love The Glove: Ten Great Reasons To Use Condoms You Might Not Have Heard Of Yet. It begins by saying that amongst the many reasons teenagers don't use condoms one is that they start on hormonal methods and forget about STIs. The writer, Heather Corinna, goes on to refute the often used argument that condoms lessen sensation with this brilliant answer:

"Gander, meet goose. If we're going to talk about condoms changing how sex feels, we need to remember that something like the pill does too, and, unlike condoms, it changes how a woman feels all the time, both during and outside of sex. And as someone who has had a barrier over a much more sensitive part than a penis (the clitoris) and has also used hormonal medication can tell you (and that's on top of knowing the data I do as a sex educator) a latex barrier, when used properly doesn't change sensations more than most methods do for women. Other methods of contraception can cause pain and cramping, unpredictable bleeding, urinary tract infections, depression and a whole host of unpleasant side effects. Condoms are the LEAST intrusive and demanding of all methods of contraception, even though some guys talk about them -- without considering this perspective -- like they're the most. If guys could feel what life can be like on the pill, use a cervical barrier or get a Depo shot, they'd easily see condoms for the cakewalk they are."

I was reading in Barbara Ehrenreich's Remaking Love: The Feminisation of Sex the other day that although we have come to see the pill as synonymous with women's sexual liberation and the catalyst for the freedom of the 1960s, before its release women were carrying diaphragms around in their purses. The pill, she argues, only legitimised a social shift already underway.

Just as we have become so casual about the pill that many women do not consider it a drug, we have become very flip about condoms and accepting of all the myths surrounding them. As is mentioned in the above article there are ways and means of using condoms that would make them more attractive to those who insist they dislike the 'intrusion' of this method in comparison to the invisibility of the pill. If we were to have more of these conversations then we might find ourselves in more communicative relationships having much more satisfying sex as a result.

I am in the middle of reading Charlotte Roche's Wetlands - a novel from the point of view of an eighteen year old woman who is utterly fascinated by bodily functions in defiance of the sanitised image of femininity. I think the style is called gurlesque - a blend of grotesque and burlesque. I started out flinching, but it didn't take long to get used to. She details everything, her secretions, her toilet habits, her sex acts - you're better off reading it than working out from my prudish descriptions what it's like.

I also received my kit for the fertility awareness method in the post, complete with workbook and thermometer and so am reading through that at the same time. They compliment each other very well, meeting in the middle with talk of mucus textures. Reading about the fictional Helen making tampons out of toilet paper is making me a whole lot more open to charting my monthly cycle. Coming into my third month off the pill now and despite all my testosterone putting its efforts into making my skin and hair horrid, and avoiding its other duties, I am feeling relaxed and balanced. Also no more of the massive tension headaches I have had every week for the last couple of years. All these signs of nervous anxiety are slowly slipping away.

Misguided

2009-12-04T11:47:00.001-08:00

I think I might need to revise one of the statements I have made over and over on this blog, but then I guess that is some of the fun of a blog - you get to see the evolution of ideas. I've been reading a bit more about Margaret Sanger, the lady who helped bring about the release of the birth control pill. I'd been thinking on how she fought for freedom of choice and education, and I'd previously argued that the way the pill is presented and pushed to women these days has undermined the original motivations behind its creation.

But just this week I found out that although she was involved in the feminist and socialist beginnings of the pill in the early 1900s, as she came up against opposition she changed her take on the campaign quite drastically. She advocated the pill as a tool for stopping the 'wrong' people having too many children - 'wrong' in her mind being the poor and/or the 'feebleminded' (particularly after the invention and promotion of the IQ test). Her views were very overtly racist and classist, basically suggesting the pill should be used as a method of eugenics. You might remember I talked many posts back about how the pill component was created under Nazi experimentation to sterilise the Jewish people in concentration camps.

The UK's NHS started a new public awareness campaign aimed at young women this week. It's about informing 16 to 24 year olds on what types of contraception are available to them and how to avoid getting STIs, or getting pregnant. This is great, of course, and clearly miles better than the abstinence-only rot they try and sell here in the US. However, I have been watching some of the videos online, and reading the information, and there appears to be a strong emphasis on hormonal methods, and particularly long acting methods like the injection, the implant and the hormonal IUS. Of the 15 methods mentioned - yes, at least it's not just the pill - most of them are hormone-based.

One of the adverts shown on TV works from the point of view that it is too difficult for young women to remember to take the pill every day - and that it doesn't fit in with their 'lifestyle.' The long acting methods are given as an answer to this assumed problem. In the information given there's very little said about the possible side effects of anything, and the one mention made that some women might want to avoid hormonal methods is not backed up with any explanation. Also, oddly, condoms are kind of weirdly undermined as an effective method in some places, and then supported in others. Considering the rising number of people with STIs the whole discussion is heavily weighted to methods that only prevent pregnancy.

I've talked about this trend before, which I have seen in magazine articles criticising the pill - this push towards the injection, implant and IUD which entirely ignores the actual reason the pill causes women problems - the synthetic hormones. The main benefit suggested by the NHS representatives for the long acting contraceptives is that they stop menstruation entirely. No talk of stopping ovulation, or the entire bodily process, of course. I tend to see the NHS as a benign entity, but I don't like this spinning of the facts here. The pill gives over control of women's bodies and reproduction to medical authorities, but the injection, the implant, the hormonal IUS signs us over entirely to this system. You need a doctor to administer these methods and you need a doctor to remove two of them. You don't even get to choose to stop taking them one day, like you can with the pill.

I think the promotion of these long acting methods is not unrelated to the eugenics foundations of the pill. As I have said before, the injection is more often administered to young black women than any other group of people. It is also used liberally in developing countries. I think these methods illustrate a profound lack of respect for women. It's worth saying again that the Depo injection is used for the chemical castration of sex offenders. The same injection is being given to one in five African American women. Even if I didn't know that for some women the injection, implant, IUS will impact horribly on their mood, well being and general health, I would still be very suspicious of this insistence on such contraceptives being an improvement on the pill. It's as though it's understood now that women are becoming concerned with the pill and these replacements are being ushered in that are actually more effective than the pill in divorcing women from their bodies, crudely sacrificing their health to the greater good and eroding their mental and physical wellness.

I have been in contact with another journalist lately who was curious as to why the carcinogenic quality of the pill is not widely discussed. She has been asking around, government bodies etc, and she keeps getting the same answer - that because the pill reduces the risk of ovarian and uterus cancers the fact that it increases the risk of breast, liver and cervical cancers is negligable. And the 'greater good' benefit of preventing population increase is the overriding factor for the discussion of any negative side at all. It seems it is believed that anything can be done in the name of population control.

I have been thinking about this population control argument recently. Thing is, widespread poverty really isn't down to there being too many people in a country, it's down to the distribution of the services and resources available. It's about the very very rich having control over the majority of resources, it's about poorly managed welfare systems, corrupt governments, the poor being blamed for their own poverty by pseudo-religious administrations...so so so many factors other than how many people get accidently born.

Population control is a phony argument that only serves to promote the status quo and keep people believing there's nothing else to be done about poverty, which lets the rich keep getting richer. I understand in developing countries women can be in real danger when pregnant, as can the baby that is born, because they don't have access to hospitals, clean water, or food. But is the answer to sterilise them and use their poverty to persuade women in developed countries to be injected, implanted? I dread to think what little the women in developing countries are told about the injection. Seems to me like a crude fix for a much much larger issue, an issue that it is hoped will be forgotten as a result. Also, interesting how this perspective kind of blames the state of the world entirely on women and makes it there sole responsibility to solve. Something rather Biblical about that.

I had my attention drawn to a study this week that suggests that young women's menstrual cycles should be considered a useful, important indicator of their general health. It was proposed that doctors should consider the menstrual cycle to be as vital a sign of good health as regular blood pressure levels and monitored in a similarly attentive way. Irregularities in a cycle, such as overly heavy bleeding or prolonged time between periods, can be a sign of many problems that might otherwise go unnoticed and worsen over time - illnesses such as polycystic ovaries, thyroid disfunction, cushing's disease, adrenal tumours, but also problems such as anorexia, or extreme stress. So, putting young women on the pill, or giving them the injection, the implant, or the IUS, and shutting down their cycles can mean illnesses go undiagnosed and untreated.

Apparently it can take up to six years for a menstrual cycle to mature, and settle down. Within the first three years of a young woman's cycle she can experience pain, heaviness, and irregularity as her body adjusts to the changes. This is the time in which many women are prescribed the pill, or are persuaded by their mothers or friends to take the pill - when they are finding their periods hard to deal with. The cycle will generally even out if left alone, but it more often 'dealt with' quickly with this medication. For many women their only experience of their cycle is at this early, sometimes difficult, stage. Memories of this time often keep them taking hormonal treatments long term and not questioning the logic or reasoning for this decision. We want to avoid having to experience the pain and all that again.

I can say myself, my menstrual cycle is way more manegeable now at 26 and off the pill than it was before I went on the pill at 15. I think doctors are way too eager to put teenagers on the pill, and their parents are more than happy to support this. The NHS campaign wants young women on synthetic hormones as soon as possible as it is seen as the only assured way of avoiding a lot of pregnant teenagers. Of course, the UK has a massively high rate of teenage pregnancy so they are paranoid. But instead of educating them about how contraception works and what it is that contraception is doing that stops them getting pregnant, and how getting pregnant happens and when and why, they just want to sterilise the lot long term - it's easy, and looks like some real action. Considering the little I knew before starting this blog about my body, I can only assume there's plenty of teenage girls out there entirely clueless and as such won't be using contraception effectively.

Also the message is that menstruation - which they use in the campaign as shorthand for the entire montly cycle - is a completely unnecessary process unless you want to get pregnant. It really does seem implausible that the holistic, whole body effecting, function of the cycle is unknown to so many GPs, or that they really do think it's just a matter of stopping periods. I mean, I got a B in the lower level science GCSE and I understand this after a little reading and realising. The facts are being spun for the 'greater good' here, and individual young women are seen as unimportant in comparison to what hormonal birth control means to society.

Then again though - the supposed bastions of women's liberation, the inner circle of feminists, as in the people who are supposed to be on our side, came up with this bunch of ignorant nonsense last year when the continuous contraceptive pills came out like Seasonale:

http://www.msmagazine.com/Fall2008/LikeANaturalWoman.asp

I can't believe a magazine as smart-seeming and intellectual as Ms. believes the falsity that the pill 'regulates' the cycle and that no one in their offices has ever read a book by Barbara Seaman. They ask us to criticise Big Pharma? Here, here, but Big Pharma would love this Ms. article

Follow the money

2009-11-25T14:39:00.000-08:00

I just came across this film that hasn't had a cinema release yet, called Orgasm Inc, directed by Liz Canner - she took a job as an editor for a pharmaceutical company, editing erotic movies for test trials of versions of 'female Viagra' - like the drug I talked about in the last post. She investigated from the inside the billion dollar industry built around finding a cure for what is labelled 'female sexual dysfunction.' She discovered there has been a race on for a long time to come up with a marketable drug of this kind.

I've been thinking a lot lately about the pharmaceutical industry. I found out last week that Bayer Schering Pharma want to contact me, well the company's 'local drug compliance officer' wants to contact me. To me, that title sounds like something out of Minority Report. Is the suggestion that I need investigating because I am not complying with their drug? Or that they want to improve compliance by talking to me? How can a person be compliant to a drug? It's a bit like 'loyalty' cards for supermarkets - can a person be loyal to a company? Compliance seems to mean that you take the drug, and keep taking it no matter what, and like it.

Anyway, so, yes, thinking about the pharmaceutical industry lately - that 45% of the female-orientated side of the industry springs from oral contraceptives is quite amazing. The mood side effects of the pill I am discussing here - the anxiety, the depression, the fatigue, the panic attacks, the fearfulness that many women experience - could actually be seen as bolstering other areas too - such as the sales of anti depressants and mood stabilizers, and the invention of a 'female Viagra.' In a sense, it is useful for women to have 'female sexual dysfunction' - which basically means low libido and depression - and to not link that to the pill. I know I am going over old ground. Keeping women feeling sickly must be a booster for all sorts of other areas of money-making. I watched Sicko again the other day, and Tony Benn said something similar about how a sick, anxious public is an easily controlled, easily influenced, passive public.

I wonder if there are any statistics out there on the number of women on anti-depressants and on the pill. I know they hand them out to everyone these days, but that would be interesting. There's a doctor, Irwin Goldstein, who believes the pill has much to do with this 'sexual dysfunction' idea. It's not enough to convince healthy people they are sick - with social anxiety disorder and all that - it must be even better to make sure that half of them are sick, and sick because of a drug they don't even notice they're taking.

I had a a bit of an altercation on the comments section of my guest blog for the Society of Menstrual Cycle Research - someone, I thought perhaps this drug compliance officer - took issue with my lack of 'rational' research. I have contacted most of the research scientists who have looked into the impact of the pill on mood and well being. There isn't an awful lot of research on this to read. But whilst I was addressing the criticism I thought how most of my discussion of late has come from the very factual, rational understanding that the pill suppresses and stops the natural ovulation cycle.

Laura Werschler, executive director of Sexual Health Access in Alberta, contributed to the comments section also. She insightfully pointed out that there is research available into the benefits of the natural ovulation cycle for women's bodies - for their immune system, hearts, bones and general wellness. In a letter to Ms magazine she commented that we should not just be asking what the pill is doing to our bodies, but what natural cycles can do for us.

I have tried to point this out here, but it bears clarification. Side effects of the pill are experienced by many women, but not all in the same way, and not all at the same point. However, all women taking the pill are suppressing their natural cycle, and this does have an effect on general health. If we don't have scientific back-up for the side effects we are discussing - not that this undermines their existence in any way, or means they should not be taken very seriously - but we do have scientific back-up for the function of the ovulation cycle. Although, as Laura pointed out, many doctors, and much of the medical profession, still thinks the natural cycle is useless until a woman wants to get pregnant.

There was an article on the Macleans website yesterday entitled Ditching The Pill For Good which said that due on young women in their twenties reconsidering the pill, prescriptions for oral contraceptives have not risen in the last year. That's women like me, and perhaps you, then. The 26 year-old Teresa Lambert is the main subject of the piece. She took the pill for ten years and just came off it. She is 'watching her body change' and says, 'I always had really clear skin, and now my skin’s breaking out. It’s not awesome being 26 and having acne, and trying to figure out your periods. But I’m glad I’m doing it.' Sounds familiar. A friend pointed out to me that coming off the pill is like having a second adolescence, or even a first adolescence, if the first - and the acne, the periods - was controlled by the pill from the start. So, like a teenager, you get bad skin and bad hair and you feel very volatile, super emotional and sensitive. Your emotions are overwhelming, and kind of frightening. It's like the pill creates arrested development.

http://www2.macleans.ca/2009/11/23/ditching-the-pill-for-good/

The scientific director of the Center For Menstrual Cycle and Ovulation Research - someone I interviewed back when writing the Easy Living piece - Dr Jerilynn Prior is quoted as saying, 'There’s an emotional identity attached to achieving your own menstrual cycle, and being able to read your body. When you’re on the pill, it’s the doctor who’s controlling your cycle. You don’t own it.' She talks about the importance of ovulation, about how at that time the hormones peak and this has all sorts of positive effects.

As is the way with the internet, the comments underneath the article are just as interesting as the article itself. Many people wrote to advocate the fertility awareness method of contraception, which I was talking about last time. One man even went as far as to say that his wife being connected to her cycle, and his understanding of it, made for better sex, apparently 'sex on the pill was a mere shadow of the real thing.' So, I guess that's a good answer to people who criticise condoms too.

I don't think I've mentioned before that I ordered and read that book, The Optimized Woman. It's all about how women can make the most of their natural cycle - in a life-coach, self improving, achieving more, feeling better way. Oddly, Miranda Gray sort of says that the book should be good for women on what she calls 'medically managed' cycles, although she doesn't say how or why. I suppose that's marketing for you, needing to appeal to everyone and all that. Doesn't make any sense though.

http://www.optimizedwoman.com/

She has some very interesting points to make that overturn conventional attitudes towards menstruation which were, and are, crucial in promoting and pushing the pill on women. I have said before that I think the pill was enthusiastically received as a necessity for women wanting to get into the workplace, and work alongside men - they could choose when to have children with other methods, but menstruation, and the changes of the natural cycle were seen as making women weak, frail and irrational (and therefore not able to work alongside men) and menstruation in particular was thought to be a threat to productivity and work output. The natural cycle was understood as a handicap that held women back and could not be tolerated by the economy, the world of business, or just by men in the office.

Gray argues from within the system as we know it, using business-y language and turning the assumptions around. She says that the economy ignores the 'truth' about women. The cyclical nature of women's lives could be an asset. We have overriden our cycles to fit into a world that perceives us as inconsistent and unreliable - when the changing states women go through are actually anything but, and can be utilised by us, and by the economy, for success and achievement.

We accept the way the business world wants us to be - static, unchanging, regimented, passive - as the 'way it should be' and struggle to fit this structure rather than accepting and understanding how we are. Gray argues that the social focus on menstruation suggests to women they are 'abnormal' once a month, and 'normal' the rest of the month, which lets us lose sight of the cycle completely. If women were free to be female, and not have to fight themselves - with the pill, as I would see it - then they would be better off all round. Not only that, society would be better off too.

She splits the cycle into four sections - pre-ovulation, ovulation, pre-menstrual, menstrual - and gives them labels like 'dynamic' and 'creative.' I've posted a link to Gray's site before. It's funny to see Cosmopolitan magazine has picked up on her work with a piece on the four kinds of sex drive, of course. But it's actually pretty intriguing, and she doesn't even try to impose her own system as a replacement - admitting instead it is flexible and adaptable in itself. Shame she doesn't quite get it about 'medically managed' cycles, though.

In other words

2009-11-22T14:51:00.000-08:00

I thought it might be about time for another personal pill experience, and some writing from someone other than me on the subject. A fair few women have given their stories in the comments section also, so do take a look at those.

El is in her mid-twenties and lives in the UK:

"I was 18 and at university when I went on the pill. I had really irregular periods – sometimes 12 weeks apart – and my GP said it’d help to regulate them. Obviously my first pill (like most people’s) was Microgynon. After a few weeks I noticed how hungry it’d made me. I’d started to eat way more food than usual, and all I could think about was where my next snack was coming from! It sounds stupid, but I couldn’t concentrate properly on anything because I kept thinking about food.

I went back to my GP who prescribed me Cileste. I took this for a while but soon noticed I had really tender breasts and a bloated feeling, all the time. I changed pill again to Yasmin, but soon got thrush (ew – sorry!) I’d never had it before so I was really surprised. I did all the right things – used the medication, made sure I wore cotton, etc. But it kept coming back. I was 19 at this point.

I went to my GP again and she prescribed Dianette. I got the packet home, took out the leaflet, and read all the instructions... which said the pill should be prescribed for adult acne, and though it was also a contraceptive pill, it shouldn’t be prescribed primarily for contraception. This seemed weird, but I trusted my GP and took it anyway.

A little while after, I began to feel really miserable, and went to my GP for advice. I started crying at the doctor’s but she put it down to a recent bereavement, handed me some tissues, and I went on my way. Over the next few months I got worse and worse; I’d cry all the time and couldn’t bring myself to talk to anyone because I felt disconnected. Physically, I couldn’t sleep and night and also lost my appetite. I’d cook myself food and then feel like I was going to be sick at the first mouthful and end up throwing everything away. This went on for a long time, and really affected my personal relationships and my university grades. The only things that kept me going were my mum, my best friend and my boyfriend.

The worst time was when I went home for Christmas. My parents noticed how bad it was and my mum suggested I consider taking anti-depressants to see if that would help. I’d been determined not to take anything, but I made an appointment with my home doctor who prescribed me some very mild anti-anxiety pills to take if I needed them. I got the box of pills but decided not to take any. I wanted everything out of me system so I could decide if my feelings were part of ‘me’ or part of the pills – by this time I’d started to wonder if they were having an effect.

I came off Dianette and noticed an improvement within a matter of weeks. I felt able to cope again, I stopped crying, I was able to talk about how horrible I’d found my experiences. And I decided not to go back on the pill. Searching the internet, I found others who’d had negative experiences with Dianette. And I found out you’re only supposed to take it temporarily until the acne clears up (what acne?!)

This happened to me in 2004/5, and in 2006 the BBC published the story that Dianette was being investigated due to a link with depression: http://news.bbc.co.uk/1/hi/health/4983774.stm. It's a shocking read but makes a lot of sense to me, especially this quote: "A spokeswoman for Schering Health Care, which manufactures Dianette, said: "Severe depression is listed in the patient information leaflet as a reason for stopping Dianette immediately. Depressive moods are also listed as a possible side effect.""

While the pill might not have been /entirely/ responsible for the depression I felt, I feel convinced it played a big part and will never take it again. In my experience, GPs (especially those working with people of university age) are too cavalier about prescribing the pill, and don’t take time to discuss other options or potential side effects. While on the pill, I also leapt from being a size 32A to a 32D. This could have been a consequence of taking the pill. If not, it’s at least a sign my body hadn’t finished developing yet, and so probably could have done without extra hormones confusing it!

There are pros to taking the pill that I miss: for example, it feels nice to have sex without a condom, and it’s nice to run packs together and miss periods if they’re inconvenient. When I first started taking the pill, it also made me feel ‘grown up’. But for me, the benefits are outweighed by the negative side effects. If I’m having period pains or mood swings, at least I know it’s just my natural cycle and I can deal with it. I also have a very supportive partner who would also prefer sex without condoms but not at the expense of my happiness.

At the end of the day, I feel angry about the way the pill’s sold to women, and don’t think there’s enough information for people to make informed decisions about contraception. I would have thought twice about going on the pill (which is marketed as such a ‘normal’ thing) if I’d known then what I know now."

Who am I when I'm not on the Pill?

2009-11-20T16:21:00.000-08:00

Bayer Schering Pharma, once again the company behind Yasmin/Yaz, made an announcement this week that the Asia-Pacific market is opening up for sales of the birth control pill. Oral contraceptives are not popular in China, India, Vietnam and Japan. I have kept meaning to write here about Japan, as the pill was only legalised there at the end of the 1990s. Apparently women in this area of the world are suspicious of the pill and its long term side effects. In Japan 80% of women use condoms as their main method of contraception. This attitude has been put down to conservatism - mostly that women are not considered responsible for contraception, concerns that it might cause on-going infertility, and a dislike of the regime of daily pill taking. Even since its legalisation, and we can imagine much campaigning from frustrated pharmaceutical companies, women remain uninterested.

There's a book by Japanese writer Ayako Matsumoto titled Why The Pill Is Not Welcomed in which she argues the lack of interest in the birth control pill is partly due on the availability and acceptability of abortions. When the pill was released in 1960, abortion was still illegal in Western countries, but legal in Japan. Women at the time protested that the pill gave them the burden of contraception, plus the side effects of the drug, and allowed men to deny all responsibility. They saw that the pill was not treating a disorder, but changing the natural patterns of a healthy body.

Of course, in the news stories and discussions you can read about the pill and Japan on the web, there is the argument that Japanese women are restricted in their freedoms and the Japanese government wants to keep it that way. I think it would be fascinating to look further into this, and compare women's lives in Europe and the US. I have been talking here about how bound up the birth control pill is with the progress of women, their relationships to their bodies, and society's attitude towards them so it was be interesting to look more in depth at a country in which women work, choose relationships, have similar lifestyles, but do not take, or like the idea of, the pill.

I have read a little about how Japanese women are more interested in charting their own cycles, and working out when they are fertile and when they are not. As I mentioned in my last post, I had a talk with fertility awareness method expert Jane Bennett the other day. She argues that it is better business to keep women mystified about their hormone cycles as prescribing the pill creates a lot of money, and although educating women about their natural patterns would take time, once they had that knowledge no money could be made from it. Although I think capitalism always finds a way, I understand her point.

Phil Smits, head of the Women's Healthcare Global Business Unit for Bayer Schering, informed reporters this week that the women's healthcare market was valued at $16.4 billion worldwide in 2007, with oral contraceptives accounting for around 45 percent.

Aligning their company with women's liberation, and promoting the idea that Japanese women are oppressed is sure to help their cause. In his statement, made in Singapore, Smits also emphasised that use of "reliable" contraception was low, and as such suggested the methods chosen by Asian women, including condoms, are unreliable. By drawing Japan's attitude towards abortion into the matter, however significant this point likely is, has the effect of making the providers of birth control pills saviours of the unborn, moral crusaders fighting to stop the brutality of abortion. Of course, abortion shouldn't be used in place of contraception, but I doubt it actually is to such an extent as is claimed.

The statement was rounded off with the announcement that Bayer is working on drugs for women with menopause and "gynaecological disorders."I find the vagueness of that term worrying. What will women find they have wrong with them now? I came across an article last week that talked about 'restless vagina syndrome.' The 'female answer to Viagra' is all over the news today - Flibanserin is a failed anti-depressant now being marketed as a drug to increase women's sexual desire and what they like to call 'satisfaction.' It is also said to reduce the 'stress' caused by lack of desire, rather oddly - sounds like spin to me, suggesting that they are really concerned about women's desire and satisfaction, rather than exploiting their situation. Creepily it is explained in some articles as acting by 'decreasing inhibitions.'

The pill was supposed to help women enjoy sex more as they wouldn't have to worry about pregnancy. It used to be thought that fear of pregnancy prevented women from having the same level of libido as men. The pill, however, reduces libido in a large number of women, as it stamps out the important hormone testosterone, has depressive effects and stops ovulation. Women's libido peaks around ovulation for obvious reasons, and when you take the pill you don't ovulate. If the pill makes you feel low or anxious then you are less likely to be interested in sex. Despite the pill's popularity, and the resulting liklihood that many women with low libidos feel this way because of the pill, at least in part, we are supposed to get excited about the prospect of taking another pill to deal with the side effects of the first.

This development has already been greeted with the usual talk over how complicated women's sexuality is, and how it includes the complexities of their relationship, their self-image, their feelings of stress. Now, this is all true, but it's irritating how such discussion ignores the biological side, when that too exists and is important. Women are effected by testosterone levels like men, their libido is linked to their hormone levels. Pretending they aren't just allows further justification for any and all messing around with these hormones. Also, one of the most irritating assumptions to be used by both sides is that frequency of sex signifies interest and desire for sex, which is completely wrong. Just because women are having it more, does not mean they want it more. Unfortunately.

I imagine they are hoping it might get to the stage where the mere availability of this drug will force women to take it - if women can want sex more just by popping a tablet, why would they not want to? If they don't want to, what is wrong with them? And so on, and so on.

Some, well many, other interesting points came up in my conversation with Jane - she talked about the "slow creep" of the symptoms of suppressing your cycle with the pill for years. Even if you are super healthy, the pill blocks nutritional uptake, so any conditions you have or may be prone to can be provoked or worsened. She suggests that women coming off the pill should make sure they are taking good vitamin supplements and eating very healthily so your liver has the chance to clean out and clear. The healthier you are the better you will feel throughout your natural cycle.

I have been feeling far clearer this week, around two and a half months after stopping the pill. I am energetic, motivated and more, well, reasonable in my outlook and responses. I met a woman last night who related her own coming-off-the-pill story to me - she said she felt like she was 'human' again, and that the range of emotions suddenly available to her to feel and experience was shocking after years of numbness and nothingness. We talked about how if you take the pill through your teens and twenties and then stop, it's hard not to feel like you may have missed out some pretty important elements of living by being so mentally and emotionally cut off.

A study involving 900 women over a ten year period in Germany found the fertility awareness method to be a very effective form of contraception. As I have said before, it's not the same as the rhythm method - involving instead charting your temperature level and the consistency of the discharge you produce through the month. I found the study a very interesting read, particularly considering that this method is rarely openly discussed. I am intrigued, mostly at this point because I think it would be helpful to be aware of my body's changes and feel connected - I figure it will make coming off the pill less worrying. Jane is going to be sending me a home kit to try out for myself - so I'll let you know how I get along. I will be sticking with the condoms and spermicide for now, but as Jane says, it's good to find out about your body regardless and take back a sense of control and confidence.

http://humrep.oxfordjournals.org/cgi/reprint/dem003v1.pdf

Not so fast

2009-11-13T12:30:00.000-08:00

I've written before about how the release of the birth control pill was, in my view, as much an economic and social necessity existing to push forward the status quo as it was a radical shift in support of women's progress. Now, after reading The Beauty Myth - and I'm aware I am very late coming to this one - I am starting to wonder if the mood side effects of the pill that I'm discussing here are actually just as useful and necessary for the continuation of life as we know it too, and that this might be part of the reason why the whole word seems so nonchalant about doling such a drug out.

Perhaps I'm beginning to sound a little paranoid, but I think that's actually natural considering the complete lack of criticism out there, and rather aggressive supportiveness of the medicating of millions of women on very faulty logic. Naomi Wolf does mention the pill in her book, she says that when society needed sexually available women for the economy to grow and expand - as I talked about with Susan Faludi's Backlash - the pill was marketed as a drug to keep women young, beautiful and sexy. Young, because they were in biological stasis I suppose, beautiful because they were no longer doing that messy, unattractive menstruating and sexy because they were always available with none of the worries of pregnancy.

She also says, in discussing the ideals of attractiveness and the hamster wheel of keeping up your appearance, that "passivity, anxiety and emotionality" are needed for the economy and the culture that supports it to thrive. Women need to be both "sexually available and sexually insecure" to be good consumers. The more worried, self doubting, unconfident and fearful you feel - the more you will buy - as buying stuff is comforting, soothing with all its promises of making you, and your life, better. Funny then, that the pill makes women sexually available, in that they are assumed always ready for sex, and it makes many women feel insecure. If they can leave the house without having a panic attack, then, yes, they are probably buying clothes, make up, anything to feel a little better for a moment. I know that's what I felt like doing when I was low, so I doubt I am the only one.

Wolf doesn't talk about the pill further than stating the original marketing techniques - which are, of course, exactly the same as those used for the latest birth control pill, Yasmin. But, much of what she discusses, particularly about the plastic surgery industry is applicable and enlightening. She argues that society does not care about women's health or appearance, however much it might appear too, the only concern is that women keep being happy to be told what they can and can not do. Women's ovaries had long been battled over by the medical world before the pill came about, but once it did, women's whole reproductive system was made collective property. Women might 'choose' to take the pill, although as you know I think the popularity of the pill is destructive to that choice, but essentially they have handed over their reproductive organs to the control of the doctors, the pharmaceutical companies.

There's much said about how the pill 'protects' a woman's fertility by basically stopping the site of fertility functioning, thus preventing any problems arising - in the way that if you never drove a car it wouldn't need new brakes, new tires. The pill can actually mask many problems a woman might have, which then would only reveal themselves when in her thirties she decides to try to have a baby. Also, it can take a long time for a woman's natural state of fertility to return, holding the woman ransom to her bodies ability to process the chemicals it's been taking in for years. But, the falsity of that assumption aside, the idea of 'protecting' a woman's fertility is in itself controlling. It used to be that doctors thought women were intrinsically mentally ill and morally weak and that the repurcussions of this would effect her ability to have children, which led to doctors dictating what women could and could not do with their lives.

The pill perpetuates the fear and mystery surrounding women's reproduction ability and sexuality. The existence of the pill does not suggest society has come to accept women's bodies, or just plain women, nor does it suggest that society understands women's bodies. The pill is a rejection of women. It is a rejection of femaleness. The pill helped bring women into the man's world, and make them acceptable to work alongside men, but it did so at its high price. Women had to make a sacrifice to have some power. Society would not change for them by changing its structure to include child care, parental leave, felixible hours or even change its culture to be more compassionate, caring, human. Instead women had to change and fast.

John Galbraith is quoted in Wolf's book: "Behaviour that is essential for economic reasons is transformed into social virtue." Women who don't want to take the pill are treated as odd, abnormal, by doctors who often see the pill as the only choice for contraception. Women are thought ungrateful if they do not want the pill - here's this wonderous, liberating drug that was fought so hard for, how can we turn it down? The idea of the pill is still saturated with that radical spirit, even though it is now taken so casually. Wolf points out that women are indeed, at least in the western world, able to live much healthier lives - there are less threats from sex and pregnancy than there were before, but because the progress of medicine and hygiene has allowed us to be free of this vulnerability, it has been made certain that we are unable to experience our wellness. She was talking about the oppression of the beauty myth, but the statement could equally apply to the pushing of the pill.

I found a book in the library, Elizabeth Draper's Birth Control In The Modern World, published in the mid-1960s. In it, she argues that the pill should not be considered the pinnacle of contraceptive reseach achievement, that science should keep searching for a better method. She discusses previous attempts at creating oral contraceptives that would not intervene with the physicality of sex - drinking water used to wash dead people, eating honeycomb containing dead bees. One statement stuck out for me:

"It is one thing to use on a short term basis and in urgent therepeutic need drugs whose long term effects maybe in doubt, and quite another to use a drug for a purpose still imbued with an aura of questionable self-indulgence and for which alternatives exist. The oral contraceptive is a drug, a drug on the poison list, and one only available under medical prescription."

This related to something I found interesting in The Beauty Myth's chapters on plastic surgery. The Hippocratic Oath forbids experimentation without therepeutic purpose. Barbara Seaman, women's health agitator, was fond of calling the birth control pill a massive experiment on women.

Two and a half months into coming off the pill and I'm feeling brighter, but still disorientated. It's like having to relearn how to react, and feel, naturally. Natural feelings in their depth and intensity can be overwhelming. The flatness, if not the episodes of feeling insane, provided by the pill is a real contrast to the fullness of feeling that's slowing coming through the haze of chemicals. Talking to Jane Bennett earlier this week I discovered the liver processes all the pill's chemicals and so when you stop taking it, the liver is still working hard to clear the chemicals and get back to working normally and healthily. If your liver is clogged up then that can make you feel tired, down and quick to anger. A lack of patience or tolerance is often associated with a sluggish liver. It's like a pill-taking hangover.

Silent bodies

2009-11-09T11:48:00.000-08:00

http://menstruationresearch.org/blog/

My guest blog for the Society for Menstrual Cycle Research was published this morning. The editor saw fit to give the piece the title, 'Are we addicted to the pill?'- drawing my attention to a line of thought through my writing here that I hadn't previously paid that much attention too - the thought that we, as individuals and collectively, are addicted to the pill, and that the pill has become so fundamental to the workings of the world, or at least the western world, that the issue of women taking it or not taking is now amazingly complex.

It would be fair to think that taking the pill was solely about avoiding pregnancy. After all, that's what it was invented for right? But we know that it is also prescribed for poly cystic ovaries syndrome, heavy bleeding, and acne - to name really only a few of the reasons I've heard doctors give. The papers this week have been full of the news that the pill might help women suffering with asthma. Most of these articles mentioned somewhere, in some way, that the pill is 'the most researched and safest medication' around.

Now, from what I know about the pill's impact on the body there's a good chance it increases the likelihood of developing allergies, or worsening allergies, due on its suppression of the immune system - however, I am happy to accept that it has been found that some forms of asthma can be helped by the pill. I'm not so happy that it is thought acceptable to treat this problem with a drug that shuts down the hormonal cycle and has such wide ranging effects on all bodily functions. Once you know something about how the pill works, prescribing it for anything - even its presumed main reason for being - seems very drastic. Like cutting someone's arm off because they have arthritis in their wrist.

The pill is often cited as giving protection against ovarian and endometrial cancers. This protection comes about because these organs are not functioning when a woman is taking the pill, and if they are not functioning they aren't alive to developing cancerous cells. I have also heard it said that the pill protects a woman's fertility. Again this is because her reproductive system is dormant and as such not open to certain problems. I won't deny the veracity of the first statement, although I would the second, but both come from an understanding of women's bodies which is worryingly negative. It is assumed women's reproductive system is intrinsically hazardous, dangerous, not to be trusted and only useful, or good, when creating a baby. This to me seems a little like saying living is dangerous, because it can result in death.

Alexandra Pope, co-author of The Pill: Are You Sure It's For You? calls the side effects of the pill "quality of life threatening." Many women take the pill, and ratio-wise, not that many of them die of pill-related blood clots. But, I believe many women suffer a poorer quality of life when taking the pill, and that the effect of this daily wear and tear on their well being, and their basic, necessary bodily functions such as metabolism and immunity, is serious. I have not died from taking the pill, but I have spent months feeling very unwell and unable to enjoy life, and many years feeling less than healthy. The twin ideas that women are naturally, as women, always sick and that women are inescapably emotionally erratic are ingrained in our minds with the same casual ease as our knowing how to eat a banana or use a knife. We think the way the pill can make us feel is normal, and that essentially, we don't deserve anything else.

Speaking of normal, my guest blog was proceeded by an interesting post from Moira Howes of Trent University. She discusses a statement made by Timothy Rowe, Head of Reproductive Endocrinology and Infertility at the University of British Columbia: "The pill keeps a woman's reproductive organ's quiet and healthy." Rowe argues that this 'quiet' term is unscientific and as such laden with social values and assumptions. It suggests that an active uterus is unhealthy, if a dormant one is healthy. She brings up an idea from the medical field that apparently has only come about recently - 'incessant ovulation' - a term which implies uninterrupted ovulation, as in not suppressed by the pill, is unhealthy. When the uterus does not contain a foetus it is seen as doing nothing at all.

Let's take another look at that edited list I've posted before of all the bodily systems effected vitally by the monthly hormone 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

Two women commented on my guest blog, both remarking that in either not wanting to take the pill, or in finding the pill made them unwell, they were considered by doctors, and friends, to be 'abnormal' or 'unusual.' I have spoken to doctors previously for interviews who have complained that much of the research done into the menstrual cycle uses the cycle of a pill-taking women as its basis, as though that were more normal than the cycle of a woman not taking the pill. When the pill is called 'the most researched medication in history' it has to be noted that the medical profession has a tendency to come from the point of view that modern women's cycles are not normal - they have too many periods, too few pregnancies - and it is far better to have a 'quiet' uterus.

I don't want to demonise doctors, and I don't actually blame them for all the times women try to talk about the pill's side effects or find out about alternatives and they don't help - they probably truly only know what they're told in medical school and they probably don't have time to do the sort of reading required to understand. It's important women take responsibility for themselves, in the most meaningful way, and for each other.

I've often heard people worry over the drugs given to those with mental disorders, and how they will have to take them forever, and have heard many stories of people who have tried to stop, reluctant to take a drug for their whole life. These drugs hold their own problems for sure, and stopping them is inadvisable for some and can have terrible consequences. Yet we are it seems entirely unconcerned that millions of women take the birth control pill until menopause. And we are, as a society, entirely opposed to having them stop taking it, even though the worst that can happen for most women is withdrawal symptoms, which if you are aware that's what they are, although nasty are bearable. It's a state-sponsored addiction...

- the basis of which is, as I have just read Naomi Wolf describe in The Beauty Myth, "the dread of lost control" - control over our own bodies, and control over us.

The change

2009-11-05T13:51:00.000-08:00

I picked up a copy of Bust magazine for the first time yesterday and it contained two birth control related articles - one about a new female condom, and the other about the fertility awareness method. I'm beginning to wonder if there's a whole lot of women coming off the pill at the moment, either in direct response to the negative news around Yasmin or because of a more general growing consciousness of the lack of choice, individual and social, in taking the pill.

I came across an article on ABC news about withdrawal problems experienced by women coming off the contraceptive injection Depo Provera. Women had written in to them complaining that even if they had been fine whilst on this medication, once stopping they experienced bad mood effects, nausea and headaches. The final quote of the piece from Dr Louis Weinstein typically waves away these issues, saying that it wasn't "fair" to blame the injection when it could be any manner of other problems in the women's lives.

This of course is true, and pretty difficult to argue against, particularly if you are one woman in Dr Weinstein's office. But I'm right now trying to think of any other drug a person could take that would be so easily dismissed as the cause of physical and emotional changes. Even if the answer is to give a person another drug to combat the side effects of the first, it is rare that the drug is so willfully pushed out of the equation. The doctor's attitude is given support with talk of the benefits of the injection in terms of preventing unwanted pregnancy in unreliable teenagers not trusted with the pill and, worryingly, young women with learning difficulties.

That's all very well and good, although of course it isn't, but it is not a good enough reason to dismiss the possibility of side effects entirely in some sort of utilitarian ruling of the greatest good for the greatest number. It sounds a bit like the argument used to support vaccinating children, except women won't die or cause others to die if they don't have the contraceptive injection, and there are other choices available to them that do just as good a job of stopping pregnancy.

I've been concerned to see that a couple of articles on the side effects of the pill in magazines lately have suggested the injection, the patch, the ring and the implant as alternatives. I worry that negativity surrounding the pill will focus on the lack of offered alternatives rather than the reasons for its side effects and therefore usher women towards other hormone-based methods rather than other non-hormone based methods. The injection, ring etc might well be fine for some women, but they still act to suppress the natural hormone cycle just like the pill. And a woman is less in control because she can't just decide to stop if she feels unwell.

This population control issue has been gaining ground recently with environmentalists. Luckily, those same environmentalists tend to think women shouldn't be peeing a lot of chemicals into the sea too so they aren't backing the pushing of the pill. As I have said before if criticising the pill causes unwanted pregnancies this only goes to highlight how important it is that we all get over our myopic view of contraception and talk about alternatives so women know how to use them if they want to.

Anyway, so withdrawal symptoms - as I have been saying, the pill can have withdrawal effects. If I think back to how I would be on the week I would stop the pill every three months - tired, achey, feverish, like I had the flu - it makes sense that I would feel bad when I stopped entirely. I have had a couple of meltdowns this week of the kind I haven't seen since my Yasmin experience. It's not that I wouldn't expect to be feeling somewhat low and worried in my life right now, it is more that I am much less able to cope with feeling that way. Rather than having a grasp of the feelings and an overarching rationality when I start getting stressed it's like quicksand. The connections in my brain and body that are meant to kick in and calm me down, and the wider perspective that should be revealed, are lost, and I just look deeper into the big black hole.

It gets very dull to keep repeating the obvious - women who don't take the pill feel bad sometimes too - but I think if a lot of women are coming off the pill right now then it is partly due to wanting to feel better than they have been, but also partly because - as Hannah remarked in the last post - they want to know if they would be experiencing life in a brighter, happier, more relaxed and joyful way if they weren't on the pill. Women are curious to know if after five, seven, ten years their true perspective and nature is different. Of course, as Hannah said, it might not be.

That upon stopping you might suddenly feel particularly bad probably causes many women to go running back to the pill. Also the fear of pregnancy, and the effect that might have on your sex life and relationship must test some women's resolve. Both these issues have certainly tested mine.

As you might be able to tell from my posts I'm feeling rather foggy-headed this week and less motivated than before. There's always that nagging worry that this won't pass, even though I've heard from tons of women who say it does. On the other side there's the knowledge that with the pill all out your system you can't rely on it as an explanation for your moods, even if like me you struggled a long enough time to realise the pill could be the cause.

It's like some weird abusive relationship of co-dependency - once you know the pill's effect, the lack of control and self-understanding fostered through taking it then makes you reluctant to take responsibility for your moods. If you are left wondering who you really are and then feel pleased to have some power from your knowledge of the pill, it can be sort of scary to carry on without it. I'm pretty sure next time I'm stressed out, in a couple of months or so say, I will be able to cope, but I feel so detached from my self at the moment it's difficult to be sure. Of course it's this blurriness of lines when talking about mood and emotions that has held back acknowledgement of the potential impact of the pill.

The FDA has approved a new female condom named FC2 and made by the Female Health Company. I liked this statement from a WHO study about the motivation behind the creation of FC2:

"Globally, health and human rights advocates have been demanding that scientists develop fertility regulation methods that are safe and reversible, under the control of the user, not systemic in action, which protect the user against STIs and HIV, and do not need to be provided by a health service. The female condom comes closer to these requirements than any other family planning method."

I also found this instructional video sort of fascinating. Like I said before, a lot of these alternative methods seem so hokey and silly precisely because many of us are lifetime followers of the pill and have had little to no experience with anything else other than male condoms. The pill's cultural dominance has made female condoms seem bizarre, when actually they look easy to use and quite sensible.

http://www.femalehealth.com/theproduct.html

I'll talk about the Fertility Awareness Method next time. It's not like the Rhythm Method at all, and although I doubt I'll ever be brave enough to use this way alone as contraception it is actually very useful in terms of helping women gain confidence in their bodies and to feel in control and secure once they come off the pill. Not only does it allow you a better understanding of your body's cycle but can also give the support needed to make the leap from the pill to condoms and spermicide or something else.

It's Not Me

2009-11-02T11:07:00.000-08:00

I thought it might be a good time to let some of the women who have been in contact with me have their say. As I explained in my last post I have been feeling some nasty post-pill comedown anxiety lately which I only attributed to the chemicals leaving my system after about a week of wondering what was so wrong when nothing in my life seemed to have changed. This started me thinking of all the women who likely experience similar problems, on the pill and in the first few weeks of coming off the pill, and how most of them probably don't even consider it might be side effects. I also mentioned in my last post that I understand life has it's good and bad moments and not all times of depression can be attributed to the pill. Women who don't take the pill feel bad too. However, I also believe in letting women know the pill can be a direct cause and that its emotional impact can come about two months into taking the pill, two years or ten years. I hope these following messages will go some way to support my intentions here.

The first is from Hannah, who is in her late twenties and lives in England:

"I was initially prescribed the Pill as a teenager because of painful periods, which it didn't really help with. I think the main reason I stayed on it was because it was nice not having to use condoms, though actually in retrospect I was probably lucky not to get any icky STDs with that kind of attitude. (This is another aspect of the indiscriminate Pill usage that I often wonder about -- in my experience of one night stands the only thing that anyone ever worries about is pregnancy, not STDs, so being on the Pill is often carte blanche to have as much unprotected sex as you like.)I tried Cileste, Dianette and Microgynon, which were prescribed by a succession of GPs in response to skin problems and mood swings -- every doctor I saw was familiar with this kind of response to the Pill, and the solution was always to prescribe a different kind of Pill.

I was on and off various kinds of Pill for about six years, with long breaks. I tended to change Pill regimens at times in my life when things were changing anyway -- a new relationship or the end of a relationship, a new schedule, travelling, etc -- so I was never 100% sure if my mood swings were because of the Pill or because I was a naturally moody person. I have suffered from depression and stuff, so I'm not entirely blaming the Pill, but it definitely didn't help.

The first time it occurred to me that my anti-Pill suspicions were correct was when I visited a country I'd really wanted to go to for a long time. I was going to be doing a lot of travelling and didn't want to have a period, so I went back on the Pill just before I left. I found myself incredibly depressed within days of arriving. I came off the Pill, and within a couple of days my mood lifted again.

I had one more go at the Pill about 18 months later. I had just gotten together with my first really serious boyfriend, and we'd been apart for a couple of weeks. I went to the doctor, got a Pill prescription, and flew back to my boyfriend. I was really happy to see him. Within a few days, I was incredibly irritable, getting annoyed about everything, feeling really down. This time I couldn't find a non-Pill-related explanation -- everything else was pretty good! -- so I came off it once and for all. Even the idea of going back on it now makes me feel instantly anxious.

I sometimes wonder if my experience of my late teens and early 20s would have been different if I hadn't been sold the idea that artificial hormones were the best possible form of contraception/skin treatment/period regulation. I might have been less moody and irritable, more in tune with my body. On the other hand, maybe this is bollocks and I would have been like that anyway. What's sad is not to know.

I have always had a lot of interest and perhaps perverse pleasure in my periods -- I think it's amazing to be connected to lunar cycles and to your own fertility and your body in this way. I even like how sometimes I have period pains and am forced to just lie in bed for a few hours, suffering and thinking. So I hate the Pill not just because it made me spotty and unhappy, but because it temporarily robbed me of this really incredible aspect of being female (and no I'm not even slightly a hippy in any other way)."

And here is Lia, also in her late twenties, she lives in Germany:

"I never thought about “the pill” really: I wasn’t in a relationship, wasn't having sex, have good skin and I was afraid of gaining weight, as I’m a big girl by nature. It just wasn’t part of my life. Until I talked to some friends about problems I had been having with my period, cramps and terrible moods that just made several days per month miserable. They urged me to finally go and see a gynecologist, something I just didn’t do, out of fear of doctors - all doctors. But I tried to be an adult and went to my friend’s gynecologist.

After the check up she told me my ovaries were enlarged and if I wanted to be fertile and have children, we’d have to ‘make’ them shrink. I wondered if I should tell her that I don’t really care about my fertility, as I don’t want to have children, but just let it go. Her methods for shrinking them were: either lose a lot of weight in a short time (yeah right!) or take the pill. I took the pill.

She advised me to take it without interruption and I followed her instructions, taking “Valetta.” That was one and a half years ago. After 6 months my ovaries had shrunk a bit, so I thought it worked. Now last winter things started to change, I became much more sensitive to my environment, to people and how they behaved towards me - that pretty much resulted in crying-fits. I’d start crying for the tiniest reasons and then I wouldn’t be able to stop. I’d have a couple of crying-days per month; they had substituted my cranky period-days.

I’ve always had migraine attacks, but I’ve also always been able to sleep them off. This changed as well, I’d wake up with a terrible headache 3 or 4 days in a row, nothing helped, no painkillers, no sleep. I gained about 10 kg, which was bad, but the crying-fits were my biggest concern.

I went to see a therapist and he was the first who said that my body was maybe reacting to the pill and to not having a period anymore. My mother said the same, that it wasn’t ‘natural’ to repress your period. When I asked my doctor, she told me that it was necessary for my ovaries. Whenever she’d ask me if I got along with the pill, I’d ask her how I’d know if I didn’t get along with it. She’d answer: “Oh, trust me, you’d know.”

I didn’t connect the dots until three months ago when I did some research on “Valetta,” because I wanted to know whether I would get it when I moved to the US. I came across several blogs and chatrooms discussing side effects. Three things struck me immediately: weight gain, headaches, moods/slight depression. That was exactly what I’d been suffering from.

On my last visit to my gyno, she said my ovaries hadn’t shrunk for six months, and now, after about one and a half years with the pill and without my period I stopped taking it, without consulting her really. My ovaries aren’t shrinking anyway it seems, so I want to use my 7-month stay in the US to see if things will get better without taking it. I haven’t taken “Valetta” for two months now and my headaches are better, the rest might take some more time."

Wounded

2009-10-30T14:50:00.000-07:00

"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.

Muted

2009-10-23T15:28:00.000-07:00

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.

Corsetry

2009-10-22T11:17:00.000-07:00

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."

Pill enforced abstinence

2009-10-20T14:41:00.001-07:00

'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.

Pill pushers

2009-10-18T10:54:00.000-07:00

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.

Selling sexiness back

2009-10-16T10:33:00.000-07:00

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.

That cannon

2009-10-15T19:42:00.001-07:00

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.

Down and out

2009-10-12T11:11:00.000-07:00

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.

For men

2009-10-09T11:17:00.000-07:00

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.

Diagnoses

2009-10-03T10:33:00.000-07:00

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.

Staying fresh

2009-09-30T21:14:00.000-07:00

My research has veered a little lately - I've been reading Karen Houppert's 'The Curse: Confronting The Last Unmentionable Taboo: Menstruation' - well, I say veered, but actually it seems like discussing how women, and society as a whole, responds to menstruation is kind of crucial in explaining the trajectory of the birth control pill.

A few posts back I was wondering about my own feelings towards taking the pill and how they were wrapped up in what I felt about my body and being a woman. Houppert discusses this very intelligently in relation to how women feel about having periods. I remember feeling annoyed, angry and upset about getting my first period. I imagine that's a pretty common experience. Houppert argues that these negative feelings about menstruation stem from long upheld myths, but are also constantly stirred up and confirmed by the 'feminine hygiene' industry - the people who make tampons and pads and want you to buy them.

Obviously tampons and pads are very useful and convenient - although there are alternatives out there now, moon cups etc - so we think we buy them out of complete necessity. But for the market to be propelled, for new products to be accepted, and for lots of money to be made a certain level of compliance has been ensured through advertising that basically repeats over and over that periods are bad, disgusting, gross and having periods is shameful, unbearable, depressing. Their products are then not only used on the days of a woman's period, but even on just-in-case days and other days to ensure constant cleanliness - this is true, there's tons of women doing this.

How does this link in to the pill? Well, there are now pills available which allow you to have just four breaks a year, pills you can take continuously for years and years and never experience a period (or the not-really period you have on the pill). Women are often encouraged to run pill packets together three at a time, anyway. Seasonique is one of the continuous pills, I discovered it's been advertised heavily on the men's channel Spike TV and in the men's magazine Maxim. Why? Men don't like periods, women don't like periods, they talk and no one likes periods and so you take Seasonique.

Not all women take the pill for contraception, many take it to regulate their periods - make them lighter, more regular, less painful - especially teenage girls. I've been off the pill for around two weeks now and already started noticing bodily stuff that hasn't been going on in the last decade - stuff that makes me think - oh yeah, human body functioning. From when women are young they are taught that bodily secretions of any kind - snot, urine, sweat, period blood - are not ladylike or nice. Our bodies feel alien enough to us anyway, growing and changing at a faster rate than we can keep up with, and then we are told we must stay in control if we want to be attractive. A prescription for the pill can shortcut this requirement, making your body immediately more manageable.

And of course, menstruation is all bound up in our minds with developing sexuality, so when we suppress periods, socially we are also suppressing sexuality. Part of the pill's success has been convincing women they need to be on it always, even if they're not having sex, to control their cycle, and getting women on the pill from their early teens so they're so used to the non-periods created by the pill that real periods are even more disgusting to them than the 'feminine hygiene' industry would have them believe, they're completely alien. If women don't ever get to know what having a mature woman's body really feels like then they will never know how it shouldn't feel, or how it feels when something is wrong or unhealthy.

"If it isn't broke, fix it anyway."
Sign on the reception wall of the Tambrands (Tampax) factory in Rutland, Vermont

Next, the invention of PMS.

Noncompliance

2009-09-28T20:38:00.000-07:00

The Yasmin manufacturing company Bayer's troubles have multiplied rather quickly in the last few days. Now the Swiss medical authority Swissmedic is investigating the death of a woman who died from a blood clot ten months after being prescribed Yaz (the lower dose version of Yasmin). This story was all over the news, providing further fuel to the seventy plus law suits underway in the US.

The blood thickening effect of the birth control pill, and the consequential risk of blood clots, has been linked to the estrogen content since the first health scares of the 1960s. But Yasmin, and more so Yaz, contain low levels of estrogen and so the blood clots suffered by a number of women taking these pills have been blamed on the unique, and under researched, progestogen component, drospirenone.

Then today research was released stating that a blood clotting disorder that affects younger women - Antiphospholipid Syndrome - increases the risk 200 fold of blood clots developing in arteries and lungs if the woman is taking the pill. Women can be tested for this disorder, but until now it has only been discovered after a stroke or other medical problem has occured. All the women in the study with this syndrome who suffered a stroke or heart attack were taking the pill.

It is understood generally that the risk of blood clots from taking the pill is relatively small - that there's more to fear in crossing the road - but as the pill is prescribed so casually certain predispositions to blood clots go unconsidered. For example, we are as a race, in the rich countries anyhow, getting fatter and if a woman's BMI is over 35 she has an increased likelihood of developing a clot. Not yet widely publicised, there's an idea going around those in the research business that the pill might also be much less effective as a contraceptive in larger women. A BMI of 35 only suggests you are somewhat overweight.

Just to back up that remark about the pill being prescribed casually - I read on Marie Clair website that there's a pill about called Femcon Fe that's chewable and minty. They're handed out like sweets and now they are sweets. Because, well, all that swallowing is such a hassle, you actually have to pause and think for a second doing it.

http://www.femconfe.com/index.jsp

We've only known of the existence of hormones for the last 100 years, and here we are in 2009 chewing them.

I very much enjoy how whenever a reporter goes to a representative at Bayer to get a statement they always give the same answer, which amounts to: "What about pregnancy? That's way more dangerous, that'll kill you." Nothing much has changed since the 1920s when campaigners for contraception had to get the state of pregnancy labelled as a disease, so that they could 'treat' it with contraceptive devices and educate people about avoiding it.

Of course, if we can all be terrified of pregnancy we'll stay on the pill for longer, take it more studiously and not question our doctors. Even though the pill has never been thoroughly tested for it's longterm impact on women taking it for the ten plus years they do now as a rule. Back at the pill's beginning women would only take it when they had a boyfriend, and usually for only three years total. It wasn't taken continuously from early teens to 30 something. In fact, most of the research on the pill was undertaken on the older, first generation set.

There's something creepily called 'compliance' by the pharmaceutical companies which is of great concern to them. In terms of the pill, compliance is when women are given a pill, take it, and shut up. No, really, it's when women don't stop taking the pill, or their brand of pill, for any silly reasons like nausea, headaches or suicidal thoughts. Pharmaceutical companies are always on the search for ways to increase compliance. Hence why they come up with new 'natural' pills as we discussed earlier, and chewable pills.

They've got all het up recently because as we are in a recession and everyone has less money, or no job, women have reportedly started to take their pill every other day to spread out their $50 supply for longer than the month. Many women's insurance policies in the US, if they even have insurance, do not cover the birth control pill. They do, however seem to cover the contraceptive injection, patch and implant, or so I have heard - because I would assume it works out cheaper for them. So who knows if women are really spreading out their pills to save money, or whether that's just a way of herding us all towards these alternatives. A diaphragm, or a non-hormonal IUD, or even condoms and spermicide are cheaper - but these don't make near as much money for the pharmaceutical industry.

"Never in history have so many individuals taken such potent drugs with so little information available as to actual and potential hazards. We are embarking on a massive endocrinologic experiment with millions of healthy women."
Senator Gaylord Nelson, 1970

In the news

2009-09-26T18:22:00.000-07:00

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

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

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

http://www.nytimes.com/2009/09/26/health/26contracept.html

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

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

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

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

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

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

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

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

Testing, testing

2009-09-23T14:47:00.000-07:00

As we are on the subject of alternatives to the pill I thought we'd now take a look at the IUD. When I think about the IUD it makes me feel a little squeamish - the idea of a plastic device being put inside your body and staying there year in year out. I was talking about this to a friend, she said she worried that she'd need a doctor to take it out, and that what if, what if there was some kind of apocalyptic situation in which you couldn't find a doctor to do that, or what if all the doctors throughout the world suddenly forgot how.

An ironic reaction, I know. We've been happily putting the pill into our bodies for a good time now, and that can't ever be taken out. I think testing our reactions to the IUD gives insight, the assumptions and fears that arise help highlight how comfortably entrenched the pill is in our culture and how little we have questioned its place.

Kate Klonick wrote a piece for Slate on the IUD last month. She points to the contraceptive's checkered history for an explanation as to why just 2% of women in the US use them now. In the 1970s a type of IUD named Dalkon Shield was heavily marketed but soon linked to illnesses that lead to hysterectomies, deaths even. The side effect of pelvic inflammatory disease put American IUD manufacturers on the line, and they ended up dropping all research into the device until a decade later. But in the 1990s a study opposed the research and statistics that had sunk the IUD, finding the problems were down to a design fault in the Dalkon Shield that could be remedied. The pill has also been the subject of many health scares, none of which have punctured its popularity in this way for longer than a few months.

There are now two kinds of IUD available - Mirena and ParaGard. Mirena includes a hormone release element. Paragard combines copper with the plastic, and contains no hormones. Mirena is the second most complained about drug, after Yasmin, on most online patient forums. Klonick says the hormone release can be likened to taking one to three pills a week. If I was to have an IUD, I'd go for Paragard, as I don't see why you'd want to get a device inserted and then still have to deal with similar side effects to those you'd get from the pill.

The pill may cost up to $60 a month in the US, but if you want to you can just stop taking them, whereas Mirena costs a $300 one-off payment which I bet stops women going back to the doctor to have it removed, even if they're experiencing mood swings, until they feel they've got their money's worth. It's a double whammy for advertising - still containing hormones, which women still trust to be most effective, but containing less hormones than the pill and so encouraging to the women who have had unpleasant experiences.

The hormone used is levonorgestrel, a synthetic progestogen also found in the emergency contraceptive pill. Mirena is produced by the same pharmaceutical company that manufactures Yasmin, and can be seen advertised in just as many women's magazines. Although the Slate writer does not emphasise the hormonal element of Mirena, she states earlier in her piece that she had used many different brands of the pill and was looking for a better, hormone-free alternative.

According to the piece, there's another reason many of us know very little about IUDs and probably barely consider them as an option, a recent study in the medical journal Contraception found that 96% of education for pre-medical students on contraception centred entirely on the pill.

The doctors I've spoken to, who receive the marketing, the promotional mugs and pens and the sponsored lectures well before we all get to know about a new drug, have said that in the coming year alternatives to the pill will be more enthusiastically offered, but they will all be hormone-based - Mirena, the NuvaRing vaginal insert and the injection Depo Provera. Maybe my friend has a good reason to worry about all the doctors suddenly forgetting how after all.

Thinking over

2009-09-21T16:55:00.000-07:00

This week hormone replacement therapy was back in the news with research suggesting a link to higher mortality rates in lung cancer. The comment made by the expert in the Guardian report seemed to me equally appropriate for a discussion on the birth control pill:

Kishor Ganti, from the University of Nebraska Medical Centre, states: "These results, along with the findings showing no protection against coronary heart disease, seriously question whether HRT has any role in medicine today. It is difficult to presume that the benefits of routine use of such therapy for menopausal symptoms outweigh the risks of mortality, especially in the absence of improvement in the quality of life."

Does the birth control pill have a role in modern medicine? Does its routine use as a contraception, above all other forms of contraception, still make sense? The menopause was medicalised by HRT, just as menstruation was medicalised by the pill. In both cases, it's time to take a more progressive approach. And that progressive approach might involve a return to and reevalution of a very basic form of pregnancy prevention. Condoms.

There seems to be this universal belief that condoms are messy, intrusive, unromantic and an all-round hindrance to having decent sex. This opinion is expressed in women's magazines, in books written by doctors, in most conversations between women, between men and women, and probably between men. It's a thought so widespread that I was initially reluctant to write anything that would oppose the idea. I second-guessed myself, figuring that maybe I was missing the point, maybe I just didn't understand. But then I remembered this line said by Woody Allen in 'Manhattan.' At a party a woman tells the group that all her life she hasn't been able to have an orgasm, then when she finally did have one, her doctor told her it was the wrong kind. To this, Woody replies:

"You had the wrong kind? I've never had the wrong kind. Ever. My worst one was right on the money."

From what I can work out, condoms are universally disliked because it is thought they give you the wrong kind of orgasm, that is, not such a good one as you could be having if there wasn't a condom involved. I would like to take a look at this idea, and well, dispute it, in the most delicate way possible. From what I understand, sex of any kind, involving whatever contraceptive apparatus, tends to end up at the same point. After which what we are discussing is a matter of subjectivity in degrees.

Who really has the problem with condoms? It looks to me like there's some miscommunication going on. I don' t believe there are many women who could honestly say that their experience of sex is hindered by a condom. In fact, if a man is using a condom it might increase his longevity (see, told you I'd be delicate) and that can increase the enjoyment for women, right?

So, perhaps women think they are being nice and sympathetic and helpful to men by disliking condoms. I wonder if men actually don't like condoms, or whether we just think they don't. I reckon there's lot of men out there, and I've spoken to some of them, who dislike more so their girlfriend/wife going nuts on the pill.

I think women's enjoyment of sex is a bit more complicated than whether there's a condom involved or not, and I think men's enjoyment likely is too - in that, if you're in a good, friendly relationship, your boyfriend/husband is going to be able to handle using a condom. Also, if you're in a good, friendly relationship having the right kind of orgasm probably won't depend on a condom. If you're not in a good, friendly relationship then I would say using a condom is a great idea anyway, due on the STDs.

I can hear the other argument now: it's not about rubbish orgasms, it's about intimacy. Again, if your intimacy hinges on a small piece of rubber, I think there might be bigger problems at play.

If we are going to glorify condom-less sex, if it truly is that important to us all, then what if we made condom-less sex something to work towards, look forward to even? Like how sex in general is for the Silver Ring Thing abstinency gang. We could save condom-less sex for when we're at a point in our lives when having a baby wouldn't be so bad. Then maybe, if it is that good, all these longterm relationships will get a new lease of life upon giving up condoms.

If there are women who feel using condoms for contraception takes the power out of their hands then there's also the diaphragm and the IUD. More on that soon. But, I would argue for a reevaluation of this idea also. Why shouldn't we be able to ask men to use condoms? The insistance on keeping our 'power' in this way suggests a very dim view of relations between men and women. What's so powerless about this set-up? I don't mean to be a prude, but if you can't ask, perhaps he's not the kind of man you want to have sex with.

As I wondered in the last post, did the pill liberate men more so than women? And now, considering where the pill has got us, maybe we should take some of that liberation back in the traditional way of third wave feminism - by flipping our view of condoms, and reclaiming them for ourselves.

What's this?

2009-09-19T22:12:00.000-07:00

Here's a weird one - I just now came across a blog about Yasmin, which looks as though it is being written by a woman in her twenties relating her experiences. But the entries have marketing-type photos of the Yasmin logo and pill packets, and each piece ends with a link to a website where you can put in an order.

http://yasmin-pill.blogspot.com/

The writing style isn't obviously advertorial, it's actually quite amateurish, yet repeated over and over is the assertion that the writer believes "The Contraception Yasmin is a very effective form of contraception." Stranger still, the postings are linked to 'Benjamin Barroga' but 'Benjamin' makes statements like, " i had an extremely high sex drive before going on this pill, your talking 4-5 times a day type of couple which has gone down to 4-5 times a week if that, some days i am so tired i cant even be bothered to kiss my boyfriend never mind anything else! So the dramatic change was a shock for both of us."

The writer emphasises how much weight she has lost, how good her skin looks, and tempers her casual complaints about low libido and breakthrough bleeding with suggestions that these problems lie in an irregular pill-taking schedule, or the length of time she's been on Yasmin - "teething troubles" apparently. She picks out other pills - Cileste, Dianette - from which she claims to have experienced bad side effects - including suicidal thoughts. Each post rambles around only to end in a version of "I think you should absolutely try out the Yasmin Contraceptive Pill."

Creepy, go see for yourself. Looks like some kind of odd marketing project. Interesting to note it's only been up for the last month.

According to a piece at ezinearticles.com the blog is being written by Jackie Barroga (Benjamin's wife perhaps?) and there's even a photo of her:

http://ezinearticles.com/?Can-You-Really-Trust-the--Yasmin-Contraceptive-Pill?&id=2741348

This piece can be found all over the web if you start searching for recent additions relating to Yasmin.

Jackie Barroga's bio states, "Jackie Toto is an expert in the field of health and nutrition. After a major health scare at the age of 20, she began her conquest to search for the best natural health information available." A Benjamin Barroga is all over the internet as a doctor working in Georgia.

Curiouser and curiouser. I'm 'following' this blog now, so let's see if Benjamin gets in touch.

Choices

2009-09-17T16:11:00.000-07:00

The pharmaceutical company Bayer Schering has apparently been getting increasingly concerned about the impact of building lawsuits on sales of Yasmin. So much so that they are seeking approval to start selling a new brand of birth control pill called Qlaira (where do they come up with these hippy-sounding names?).

Already circulating is a press release calling Qlaira the first 'natural' oral contraceptive. They claim that the oestrogen component of this pill is bio-identical to the oestrogen found in women's bodies, that is it has a similar molecular structure. The oestrogen component is called estradiol valerate. When the body takes this in and metabolises it, separating the estradiol from the valerate then the estradiol part will act much like the body's oestrogen. But, really, the only truly unmanipulated, natural oestrogen is that found naturally in the body. Introducing the estradiol valerate into a woman's body will produce the same results as any other pill - replacing the natural hormone cycle with a pill produced cycle - and thus all the same side effects.

The synthetic progestogen part of Qlaira is dienogest, which is entirely man-made. Dienogest is anti-androgenic and has anti-mineralocorticoid effects the same as the progestogen in Yasmin, and will therefore have that negative impact discussed previously. A strange choice for Bayer Schering, considering it is the progestogen in Yasmin, drospirenone, that is at the centre of the lawsuits concerning women who have suffered from blood clots, strokes and heart attacks.

The Qlaira pills are marked as to the day of the month you should take them, with 28 in total. They range in colour to show the different doses of hormones contained - with four types of tablets and a placebo. The two dark yellow tablets contain 3mg estradiol, the five medium red tablets contain 2mg estradiol and 2mg dienogest, the 17 light yellow tablets contain 2mg estradiol and 3mg dienogest, and the two dark red tablets contain 1mg estradiol.

Bayer Schering's press release suggests that the synthetic oestrogen used in all other pills is inferior to this new, unique, 'natural' estradiol. It's a bit like when a laundry soap or shampoo is advertised as 'new and improved' - as though the one you've been spending your money on, putting your faith in for years is suddenly revealed as a ruse, a sham. Hopefully, the company's promotional wording might make people question what's wrong with the old synthetic oestrogen we've been taking for decades.

Be aware that in the next six months you will likely start seeing promotional pieces in women's magazines about this 'natural' birth control pill and hear doctors suggesting we give it a try, seeing as the other kinds haven't quite worked out. The Qlaira progestogen also aids weight loss and gives you glowing skin, just like Yasmin's drospirenone. A 'natural' pill that makes you skinny and beautiful, how can we refuse?

That Bayer Schering have noted a sea change of sorts and felt compelled to develop and release a 'natural' pill at this time is intriguing. Such a move suggests they are afraid of the tide turning against the pill. Before the billions could even start dwindling they were ready with a better sell.
Here's a link to the press release, you can see it says 75% of women prefer a 'natural' pill. Well, if you put it that way...

http://www.schering.co.uk/html/news_documents/080609_QLAIRA_consumer_release.pdf

"I am constantly concerned about the number of women who do not use effective contraception because of fears of risks, or side-effects they have experienced. Each completely new addition to the range of contraception must be welcomed as it gives extra choice to more women." Indeed so, Dr Annie Evans.

Book reading

2009-09-15T15:16:00.000-07:00

I am re-reading a book called 'The Pill And Other Forms Of Hormonal Contraception' by John Guillebaud, subtitled 'The Facts: All The Information You'll Need - Straight From The Experts.' I have spoken to Dr Guillebaud, he's a nice man, and his intent with this book is to give women 'all the information' as the subtitle says so that they can exercise their own judgement about how they choose to control their fertility.

The facts he presents are mostly to do with the physical side effects of the pill - arguing from a standpoint that you are less likely to die from taking the pill than from smoking, crossing the road, or indeed being pregnant. Some of it is an effort in calming the media flare ups around pill related scares.

I had never before, however, read the foreword by his wife, Gwyneth Guillebaud. In this she asks several questions: Do we still feel the same about the pill now as we did on its release? Does taking the pill mean taking control or being controlled? Did the pill liberate men more than women?

Dr Guillebaud states in his book that he believes suppressing a woman's menstrual cycle is not unnatural, explaining that for centuries women spent much of their lives pregnant and therefore did not have the number of periods women do today. He asserts that the artificial hormones used in the pill are as close to the natural hormones' make-up as possible. He argues that statistics showing the physical problems caused by the pill are skewed - women take the pill for years and as illness is a part of life, that illnesses occur when a woman is on the pill could be merely coincidental, rather than related.

When listing the negative effects of the pill Dr Guillebaud places 'depression' and 'loss of libido' in definite brackets - setting them very much aside from common physical problems such as migraines and urinary tract infections and the more serious increases in the risk of breast or cervical cancer development. Under the assessment of this much used book, such changes are definitely secondary and of less concern. Now, I'm not saying that loss of libido should be considered of the same 'seriousness' as breast cancer, but I do think that the emotional effects of the pill are overlooked. Despite their insiduous, far reaching impact on women's lives they are too often considered negligable, unimportant.

The pill's emotional effects can be debilitating. Some women feel desperate, like life is not worth living. To dismiss these issues as likely unconnected to the pill, as mere coincidences, only goes to prove how difficult it is for women to get their thoughts heard by those in the medical profession. Depression is a complex matter, and of course the pill is not the only known cause, but it can be a factor, and for the sake of the depressed this ought to be made clear.

Even in this otherwise modern, up-to-date book there is reiterated the idea that women get depressed because they are sad that they can not conceive. This statement is frustratingly Victorian in its assumptions.

In the Victorian age it was believed that if women had access to education or worked on the same pursuits as men they ran the risk of becoming infertile. The Victorian doctors felt that if women thought too much, or were over-stimulated they could lose the capacity to menstruate entirely. Some Victorian doctors went so far as to say that allowing women to learn and work would bring an end to the human race. As Lisa Appignanesi states in 'Mad, Bad and Sad: A History Of Women And The Mind Doctors' these attitudes have not disappeared . We now see the same ideas in newspaper headlines that claim working mothers are ruining their children, career women will miss out on having babies or will suffer with their inability to cope with the stress.

Back then, when pregnancy and child birth carried a higher risk of resulting in illness or death, the promotion of ideas connecting menstruation to mental breakdown exaggerated women's fear of their own bodies. They were required to be suspicious of themselves, watch their periods for signs of change and keep themselves physically and emotionally in check at all times - lest they be chucked in an asylum.

It was believed at this time that women were more disposed to mental illness than men. Much psychological understanding was based on the workings of the nervous system and it was thought that women's uterus and ovaries had a particular effect on their nerves. Women were considered frail and prone as such to many disorders. The behaviour of some GPs towards their female patients coupled with the lack of acknowledgement of the pill's emotional effects suggests to me this mindset has lived on to the present day.

http://books.google.com/books?id=BvoKKb_DfwwC&pg=RA11-PA38-IA6&lpg=RA11-PA38-IA6&dq=guillebaud+pill+ladder&source=bl&ots=KnSDbklNJH&sig=amJiSbbxd_tEEdBMHkIeKFOHcp4&hl=en&ei=KYewSpjGCILOsQOExszMCw&sa=X&oi=book_result&ct=result&resnum=10#v=onepage&q=guillebaud%20pill%20ladder&f=false

I've added here a link to a page reproduced from Dr Guillebaud's book which I have previously found useful. It is a ladder graph showing the different brands of pill arranged by the amount of oestrogen and the kind of progestogen they contain. If you do indeed want to stay on the pill, or want to try another brand, this information is good to know.

As a rule, the less oestrogen involved the better, or at least the less bad, the pill is for your body.
The progestogens norethisterone (contained in Norimin, Binovum, Trinovum, Synphase, Brevinor and Ovysmen - which are tri and biphasic pills)and levonorgestrel (contained in the popular Microgynon, Ovranette and Eugynon) are considered the safest, and should be a first choice. The pills seen at the very bottom of the ladders are progestogen-only pills (or POPs), the details of which I will address later.

Referring to this table can help you manouever your way through the pills and work out why certain brands might cause problems. But, remember, each woman's body is different in its natural hormone levels through a month, and its ability to absorb and receive hormones, so this can only provide a rough guide.

Quitting it

2009-09-13T19:23:00.000-07:00

When relating my research into the pill to men the same analogy is often brought up, I think it's a good one - that taking the pill can be a bit like smoking cigarettes. That easily irritated, emotional, foggy, out-of-it feeling that the pill can cause is somewhat similar to how smokers feel with nicotine withdrawal. Once you've been smoking for a long time, you don't even notice these changes in your day to day personality, you only can recognise the need for another cigarette. My husband has given up smoking, but just a whiff of it now and he'll be miserable the next day. He believes that smoking has far-reaching effects on your well being, your personality, that smokers just can't see happening until they stop.

A friend related how when you smoke for long enough, you become 'a smoker' and as such 'a biological extension of a medicinal parasite.' The effect of the smoking hijacks your personality, your self in that it's always there, a routine you must stick to and in that the chemicals are meddling with your emotions and experiences of the world.

When you take the pill you might not see yourself as a pill-taker (in a sense it would be better if we did) but you are doing something every day in a routine fashion that can have a major effect on you, on who you are. You keep taking it even when you have doubts, because you feel you need it and, as I have felt, it's become an unthinking habit. Taking the pill and smoking detaches you from your self, with the pill you are masking your natural cycle, and with smoking you're doing something harmful to your body. This feeling of detachment makes it easier to keep taking it, keep smoking. Through taking the pill even when it wasn't about stopping pregnancy, even when it was a secondary method of contraception, even when I knew I was experiencing unwanted side effects, I only now realise how bound up this action has been in how I felt about myself, about my life, about being a woman. There were lots of pretty complicated reasons for me taking the pill that need unpacking.

As with smoking, it effects different people differently and it's hard to study emotional side effects when we all live in the world and have experiences and not a safe, secure vacuum. But, it is helpful to know that the pill can make you feel bad so that you aren't left thinking you're flipping out.

Of course, there are women who feel good on the pill, and we can speculate that if you have a lot of trouble in your natural monthly cycle with PMS symptoms and emotional changes then having this all flattened out and smoothed down by the pill could help, at least for a while. An online survey conducted by the website Aphrodite showed over half of women on the pill experienced all the side effects we have discussed before - depression, anxiety, lethargy, low libido, but then some women complained of more specific problems no doubt related to these as sub-symptoms - loss of creativity, irrational thinking, jealousy, a constant sense of fear.

My husband will say that he wonders if the Beatles would have ever broken up if they weren't all smokers and getting irritated at the slightest thing. If so many women have been taking the pill for so many decades for such huge chunks of their lives and over half of these women have suffered from depression and anxiety then perhaps we should start wondering how the pill has impacted socially and culturally on our progress, our development. If the pill holds back individuals all the time, making them scared, fragile, unable to cope, then what has the pill done to us as a whole, as women?

The pill arrived and effectively medicalised fertility. As someone commented on my first post, this was an important event which changed views of women, sexuality, relationships. But, perhaps it's time to move on. Perhaps the pill had it's moment and it's not relevant any more. The changes provoked by its release are now concrete. Taking the pill is no longer about freedom. For many women it makes them feel the opposite of free - it makes them feel controlled. They don't feel liberated, they feel oppressed. In a very real way.

Reinforcements

2009-09-12T10:50:00.001-07:00

Of all the brands of pill out there, Yasmin is the one that really gets women talking. Some time down the line, we might see the release of Yasmin as a positive thing - it's certainly got people talking about the effects of the pill more openly.

I've heard a number of Yasmin stories in the last couple of weeks, so I thought it might be useful to look at its potential impact on your body in some more detail. The particularly nasty emotional side effects of this brand can build very sneakily and slowly, which I have found means some women go for years before they realise why they feel so wrong. Considering the massive amounts of anecdotal evidence filtering through to those in the medical profession - I've heard complaints have got so common that doctors are actually joking about it these days - I think we can assume research is being done on this pill and the negative results are not getting published.

That Yasmin immediately makes you lose weight (water weight, remember) and very quickly gets your skin glowing (wipes out testosterone, if you recall) means it's extremely effective in persuading women to take it for as long as they can stand. Those sort of instant side effects are reinforcing, and make you feel like this pill can only be doing good, healthy things to your body. That then makes you less likely to question later on whether it is Yasmin that's stopping you leaving the house or making you cry all the time.

So, what is this pill up to? Yasmin has anti-androgen and anti-mineralocorticoid properties. Mineralocorticoids are hormones, the main one is called aldosterone, which is produced by the adrenal gland and acts on the kidneys to control sodium and potassium levels in your blood. Androgens are also hormones, the main one of which is testosterone. The higher level of potassium in the body produced by Yasmin, and since the FDA warning openly advertised as a side effect, elevates blood pressure which can in turn cause heart failure. Many of the class act lawsuits against Bayer Schering are to do with Yasmin's connection to heart attacks and strokes. The progestogen drospirenone, unique to Yasmin, has been connected with an increase in the risk of blood clots.

As I've mentioned earlier, Yasmin suppresses the adrenal gland which controls hormone production as one of the ways it ensures you don't get pregnant. This suppression kicks off a lowering of serum cortisol levels, a hormone produced by the adrenal gland which guides the body's responses to stress. When your adrenal gland is put under this kind of pressure over a long period of time, it can lead to Adrenal Fatigue. Adrenal Fatigue symptoms will ring bells for women with Yasmin stories - fatigue, weakness, nervousness, anxiety, depression, brain fog, muscle pain. This illness can also show up in allergies and irritable bowel syndrome.

If you take a look at the side effects listed in a Yasmin packet, there's mention of Flu Syndrome, which as you can guess, has similar symptoms of weakness, fatigue and low immunity. In recent studies on trans-gender people taking anti-androgen medication containing similar components to drospirenone, it was found that the effect produced cognitive overload and cognitive dysfunction - that is, confusion, short term memory problems and inability to concentrate.

All of the lawsuits against Yasmin's producers are based on physical side effects, which I will go into at a later point. Clearly, emotional side effects would be harder to prove in a court, but it will be interesting to see if they become the focus down the line.

The painters are in

2009-09-10T09:50:00.000-07:00

A year ago research was released that suggested taking the pill could effect women's taste in men and lead them to choose genetically incompatible partners. Women on the pill experience a change in the type of male scent they find attractive. They are drawn to men who smell similarly to them. To produce strong, healthy children we need to be making them with men who smell differently to us - an indicator that they have complementary genes and immune systems, different to our own.

A couple with dissimilar gene make-ups is less likely to have problems conceiving, or have a child with health problems. At the time the researchers speculated that starting the pill or coming off the pill during a relationship could change your perception of your partner, make them seem less attractive. If you consider how many women take the pill and how this number has risen over the last half century and the social changes over that time you could start jumping to some wild conclusions. Like perhaps the pill is a factor behind the rising divorce rates, the rising number of single people staying single, the increase in food allergies, the increase in infertility.

Of course, smell is likely only one of many indicators of genetic compatibility. Plus I'm not keen on the nothing-but philosophy that reduces attraction, love, and relationships to biology. Perversely, considering how I am criticising the pill, I like to think we are more than slaves to the urges and desires that only exist to perpetuate survival of the human race. I've always been doubtful even of that overwhelming desire to have a child that is promised to appear at 30 and have long thought of it more as a social conditioning. But, then, perhaps that's the pill talking. My body has sort-of believed I've been pregnant for a decade now, which could go some way to explaining my lack of interest in small children.

That disinterest in biology and nature or at least, the striving to be free of what we see as our biology's restraints and what others, men, see as its restraints has been a force behind women's enthusiasm for the pill since 1960. Being rid of our woman-ness has been promoted, until very recently, as a necessity for career success. I think it goes way back to Victorian ideas of hysteria, but we'll come back to that later. I'm just starting 'Mad, Bad and Sad: A History Of Women And Their Mind Doctors From 1800' by Lisa Appignanesi.

When you're on the pill you're not ovulating, so where your natural mid-cycle would be, and you'd ovulate, and produce a rush of oestrogen, there's nothing. So, normally, you're body would have a gearing up stage, a ovulating stage, a gearing down stage and then up again. I've never been off the pill for long enough to know what this feels like, or, more accurately, when I wasn't on the pill I didn't take note of how my feelings changed across the month. I'm not an earth-mother, hippy type. Moon cups scare me. But there's successful business women out there lecturing on ways to use your natural cycle to benefit your career.

Here's a website about "using your menstrual cycle to achieve success and fulfilment" - I'm well aware of how, well, American, this stuff seems - but it's refreshing to be see a positive and active viewpoint, and it makes you realise what a lot of negativity we have been fed over the years.

http://www.optimizedwoman.com/the-optimized-woman-success.html

"The menstrual cycle is one of the most impactful influences on a woman’s motivation, energies, skillsets and perception, and it's time for the menstrual cycle to take its rightful place as a powerhouse of resources for women to use in practical everyday ways to create the best work / life balance, their full potential, goals and dreams and the life they deserve."

However cheesy, this is such a radically different perspective to what we are used to hearing. We have been taught to see periods as a nuisance, a burden and an affliction, and therefore, to view the whole cycle as something to be rid of as soon as possible. I was pleased to see Grazia had a feature a couple of weeks back on the new Australian book about the pill I mentioned before. The emphasis was on the lack of information given by GPs, with one woman claiming her doctor refused to fit a diaphragm on 'moral' grounds because it wasn't as effective as the pill.

Now, I know that they get their lectures and research funded by the pharmaceutical companies, and all those free mugs and pens of course, but that's a bit much. Maybe he was a lazy doctor, I think we forget that doctors despite the Hippocratic Oath, are human beings and thus can be lazy, greedy, careless and bored. I'm in the US right now, and it's harder to forget that here as you have to pay them directly, like you would an electrician, or a waiter. It's a consumer service, with all the suspicions and demands that go with that.

The pill is very under-researched, but it occured to me that it would surely be in the pharmaceutical companies interest to look into the pill extensively, to work out ways to make it even more appealing to women (hence how Yasmin came about), to work on decreasing side effects so women would keep taking it. The pill is the top selling medication for most pharmaceutical manufacturers, there's plenty of money to plug back into studies. There's therefore probably a lot of research in existence, funded by them, that never gets published because the conclusions aren't positive.

I've decided to come off the pill. I was feeling like the opposite of a celibate person looking through medical encyclopedias at sexually transmitted diseases (I've seen that scene in at least two movies, one was Rules Of Attraction). It's been three days.

Adding up

2009-09-07T10:01:00.000-07:00

The few studies that have been done into the Pill show a significant percentage of women suffer from depression as a side effect. These numbers can't take into account the millions of women who start taking the pill, immediately experience its negative impact and stop taking it - as many as one in ten, the majority within the first six months. But for more women the pill's side effects are insidious. Feelings of anxiety, lethargy and emotional unbalence can creep up so slowly they are blamed on a relationship, a job, a house move, a bad week, a bad year, anything but the pill.

I've been reading a book that only came out this month, 'The Pill: Are you sure it's for you?' which has distilled some of what I had previously understood about the pill's effects into a simple statement. The two main causes of the side effects experienced on the pill are the unnaturally high quantity of synthetic hormones being introduced into your system, and its impact on your metabolism producing nutritional disturbances.

Women on the pill are invariably deficient in many necessary nutrients. The depletion caused by the pill in just vitamin B12 can have negative consequences as far reaching as low tolerance to stress, weakness, insomnia and paranoia. Lowered levels of Vitamin B1 can lead to a lack of initiative, irritability and fatigue. The pill's effect on nutrient balences builds over time, which accounts for the slow development of problems, and the appearance of such problems years into a woman's pill use.

It is a good idea to adjust your diet, and take supplements - but as the effect is on your actual metabolism your body will still not be able to take in and utilise as much as it needs. If you decide to come off the pill however, eating foods high in B vitamins, zinc, calcium, vitamin C along with taking supplements can help your body return to its natural balence more quickly.

As we could guess, many women are prescribed anti-depressants to alleviate the mood changes brought on by the pill. In the past medical journals speculated that women's feelings of hopelessness and sadness could be attributed to their understanding that they were no longer able to get pregnant, a sort of mourning if you will. Still now, I have discovered, through interviews with practicing doctors, there are many who believe the emotional side effects of the pill should not be discussed openly incase the idea 'is put into women's heads' thus causing them to experience problems psychosomatically. From my experience in the doctor's chair, it's only when you initiate the conversation that they feel safe enough to agree the pill might be the issue.

But it is often the case that women will not connect the medication they take every day with the onset of disturbing changes. As I mentioned before, in the US, it's legal to advertise prescription medicines. I once saw the campaign for Yasmin over ten times during one 40 minute long TV show. Advertising like that can be particular powerful if you're feeling nervous, lacking confidence or falling out with your family and friends - powerful enough to have you keep popping the pills.

If you've never been in the US, these adverts can seem a little odd, so here's a couple of examples:

http://www.youtube.com/watch?v=uCg1q0h1PP0

http://www.youtube.com/watch?v=NoKSL8eBrW0

After that first advert came out, although it took something like a year, the Food And Drug Administration ordered that Bayer Schering put out a retraction campaign stating that Yasmin was not proven to help with 'irritability' and 'anxiety' and to make clear that any weight loss was down to dangerously high increases in potassium levels. Here that is:

http://www.youtube.com/watch?v=EO-G8O0lHq0

And here are some of the posts by women on medications.com, askapatient.com and the Yasmin Survivors Forum regarding the side effects of Yasmin. I guess googling is easy than going to the doctor, especially if you have no health insurance.

Sarah, the founder of the Yasmin Survivors group, details her side effects as 'electric shocks shooting through my body, a smothering feeling, depression, numbness in my face, hands and feet, headaches. I became agoraphobic and suffered constant panic attacks.' A woman with the username '2young4this' describes suffering with 'Brain fogginess, mood swings, panic attacks to the point I'd get stuck in a state of paranoia that would last for hours and hours, constant anxiety, nausea, lack of coordination, depression, severe stomach pain, suicidal thoughts, severe fatigue, muscle weakness. I had to drop a semester of school because I was too tired and uninterested. I lost contact with nearly everyone. My sex drive went out the window. I became paranoid and suspicious.'

Lee describes her experience, 'I have turned into someone I no longer recognize. I am angry, depressed, and emotional and I cry all the time for no reason. I snap at my boyfriend or deliberately lead him into a fight. I know what I'm doing when I do it, but I can't stop.' Wodesorel lists her side effects, 'panic attacks up to four times a day, complete meltdowns twice a week (screaming, crying, throwing things, punching, rocking, banging head), self injury and attempted suicide.' Jasmine, one of Yasmin Survivors most active contributors, describes the chronic fatigue she believes Yasmin provoked, 'I'd take a walk and be overwhelmed by exhaustion. I've been physically active my whole life and strong. I lost a lot of muscle mass and found it incredibly difficult to even work-out. All my energy was gone. I was like a zombie.'

It would have made interesting reading if I had been blogging back when I was on Yasmin and had just started finding these testimonies. But of course to be doing that, I would have needed some motivation, energy and initiative.

Coming clean

2009-09-05T20:57:00.001-07:00

I have a confession to make - I am still taking the pill. I am on Femodette. Despite writing about the horrors of the pill, talking friends out of taking it and spending many an hour pouring over the research, the case studies, the statistics, I'm still taking the pill. This, I guess, is a good illustration of the power of the idea of the pill, and the stronghold that is women's faith in it for contraception. I know all the problems the pill can cause - we've barely scratched the surface so far here -but still I carry on. Why?

I really, especially, truly do not want to get pregnant. I'm not one of those who don't want to get pregnant, but if it happened would be secretly pleased or one of those who has no plans for a baby any time soon but would be alright if it just happened to come about. I am one of those women who use the pill and condoms and still feel the need to buy pregnancy tests every other month, just to keep check. I don't know how many of us are out there, I suspect a fair few.

I think some of this anxiety has to do with the length of time I have taken the pill - since 17. I have no idea how my body feels naturally, what it would do naturally over the course of a month or how it might change were I to get pregnant. I am completely cut off from any sense of my body's physicality, its femininity. I've kind of come to fear it. My fertility is something to be fought constantly, to be suspicious of, to contain at all costs.

I have been on the pill for my entire adult life. I don't know anything else. I had two years of painful periods and then my mum, with the history of two older daughters on her mind, marched me to the doctor and they put me on the pill for fear that I would accidently get pregnant. But the pill didn't get to do its proper job, stopping me getting pregnant, for another five years. I had five years of pointless pill-taking - sure it helped with the painful periods, but there were no potential babies that whole time. I now know it is very common for a teenage girls' periods to be painful for a few years and that usually their cycles settle down and regulate. Also, I really could have put up with the pain - I have fond memories of getting out of gym class.

Soon I will have been on the pill for a decade. At the time of its release onto the market, doctors had no expectation that the pill would be taken for more than a few years. Back then, you got married young and you had babies young, and then you kept have babies. You didn't so much start having sex at 14 or wait until you were 35 to consider getting pregnant. The impact of the pill has never been properly researched over such a length of time. Side effects, as I have discovered, can turn up right away, or seven years down the line. As your body changes the way the pill effects you will change. Plus, there's the build-up effect, those hormones are filtered through your liver, and they won't just disappear when you stop.

I suppose my thoughts go along the lines of - being on the pill sucks, but getting pregnant and having to have a baby right now would suck much worse. But the thing is, I know I don't take the pill perfectly, in fact to get the same effectiveness results as advertised would be impossible as these are obtained only in labatory conditions and in real life, all sorts of stuff gets in the way, and not just being busy, or being ill. I recently found out if you're taking a lot of vitamin C in and then that stops, it can change the effectiveness of the pill. As I said before, it is known that generally women are much more careful, and much less likely to get pregnant when using condoms, or a diaphragm - the barrier methods, basically. And I'm using both. So I don't trust the pill, clearly, I don't trust it to do what it is meant to do, to do the thing that makes me take it every day and yet...If I only used the pill I know I'd be buying the pregnancy tests up in bulk.

This feels something like an addiction, or perhaps, more accurately, I could describe it as a form of Stockholm Syndrome - you know, when someone is abducted and they show signs of being loyal, or loving to their kidnapper? I am who I am on the pill, I'm not sure what I'd be like not on the pill - I would hope nicer, happier, more relaxed. I think about that and I can't believe I have spent a decade taking a medication each day without a very good reason.

I've never been at a point in my life when I can say the pill helped me as it should. No sensible person wouldn't use condoms, with STDs and all. Then when I met someone I wanted to be with properly the thought of becoming pregnant with their baby was more frightening than becoming pregnant with the baby of someone I had no feelings for, didn't know, didn't love - because I know I would find it impossible to have an abortion. I'm in no way against anyone having an abortion, and if I got pregnant from a one-night affair I wouldn't think twice. I'd find it much harder to make that choice in a long-term, committed relationship.

I've taken the emergency contraceptive pill, and experienced nothing too untoward. No side effects that is, the actualy procuring of the pill experience has left me quite beaten. Both times I was made to feel like a bad person, a bad person with the mental faculties of a five year old. I didn't get the chance to tell them I was already on the pill, but didn't trust it, so I thought I'd take another pill just in case. Then buy ten pregnancy tests and drink a bottle of wine.

I have another confession. In the last decade I have come off the pill once for longer than the standard week. Six months ago I came off Femodette for about three months. I had just finished writing the Easy Living piece. I had switched from Yasmin to Femodette four months previously and I felt much better, but the extreme emotional side effects had left me wondering. I'd started realising that some of my physical problems - endless urinary tract infections, sore and bleeding gums - were very likely down to hormonal and vitamin imbalances caused by long-term pill use. All in all, I knew the pill was a bad idea, and I was telling everyone who would listen just that, but I'd not taken my own advice.

In those three months when I was not taking the pill I felt light, stable, rational. I felt like I could cope with anything. I stopped thinking over and over and over petty worries. I stopped feeling insecure and started feeling stronger, confident. The fearfulness went away, I remembered I was young, that I should enjoy change, disruption, lack of routine and not break down over the minor struggles of every day life. I stopped feeling helpless, child-like. I felt connected with the world, and my experiences of it.

I remember one weekend in Brighton everything felt wonderful, the sunshine, the egg on toast, the gin and tonic, the futon mattress, the TV show, the conversations, the busy pub. It all felt so good it was like I was on some mood enhancing drugs. That was my only reference point, my only way of describing what was going on in my head. Back in London, I started carrying a notebook and writing down ideas, ideas with no purpose or place, just ideas - and I started having the kind of conversations where dots connect up, thoughts crackle and come to life, there's energy in what you are saying and excitement at what the other person is saying and it all feels organic, spontaneous, new, alive. The kind of conversations where you're inventing phrases, the kind you talk about for weeks after, that feed into everything else. It was like all the lights had got switched back on, all the pipes were unplugged. I had clarity.

On the pill, I had come to feel very stagnant, very still. I felt like if life didn't carry on forever in exactly the same way, even though that way didn't make me happy - I would just curl up and die. When I wasn't fraught with anxiety or overwhelmed with rage, nothing moved me. As I said in my first post, I just felt blah - an annoying phrase, but accurate. All my synapses were dampened down with wet cotton wool.

The pill wipes out all the natural ups and downs, tos and fros, grey areas and subtleties that natural hormone cycles produce. We do, literally, stagnate in the same state all the time. Our life experience is flattened. Well, apart from when we stop for a few days and the massive increase in oestrogen whacks us into withdrawal.

Three months ago I started taking the pill again. I was feeling much better, but my life was changing quickly, and the pill seemed like a reassurance, a comfort almost. I thought not being on the pill was causing problems in my relationship. I convinced myself it wasn't the right time to be 'experimenting.' Not taking the pill felt irresponsible. I was worried about taking the blame. Looking back, it appears very Stockholm Syndrome-like to me - I can't say exactly what the made me pop that Femodette back in my mouth one morning. But I know when I did, it felt right, not because I knew it was, but because it was all I had known for so long not doing it felt wrong.

Julie Burchill was right

2009-09-03T22:44:00.000-07:00

Here's some mind-twisting research for you:

Strippers on the pill make a lot less money. Strippers generally make around $70 an hour in tips when they are at peak fertility in their hormone cycle - in other words, when they are ovulating. The rest of the time they make an average of $50 an hour, except when they're menstruating - then it's $35 an hour. Strippers on the pill average $37 in tips an hour across the month, compared to the $57 average of a stripper not on the pill.

When the pill was launched in 1960 feminists believed it would liberate women, allowing them to enjoy hassle-free sex without the worry of getting pregnant. Many feminists still believe that today. Through the rise in STDs, through HIV, through lowering libidos, they've kept on believing.

I think many of us would agree that behind the pill's popularity there are a lot of women giving in to the idea, whether for themselves or their boyfriends/husbands that using a condom makes the whole experience significantly less enjoyable. I'm not sure this is true, or just one of those myths perpetuated by women's magazines. I think we should air that out, reexamine that thought.

The mind-twisting research not only illustrates the pill's insiduous, pervasive effect on your body, it's also useful as a small reminder of the necessity for reevaluation.

We can say, from this research, that the pill makes you potentially less attractive to men. Now, I'm not saying a side effect of unattractiveness should be considered anywhere near as urgent as panic attacks, paranoia or, dare I say it, blood clots. But there are all sorts of subtle, varied reasons each woman on the pill keeps taking it, and I think this research could help us reconsider our rationilisation.

I took Yasmin because I was told it would help me lose weight and get beautiful skin.

How it works

2009-09-02T18:55:00.000-07:00

It seems sensible to next answer the question of what the pill actually does to your body. That way you'll know, and be able to make an informed decision as to whether that's fine by you or not. If we have how it works straight, we can start looking at the effects in more detail. Rather than be hard-line and say no one should be on the pill - there's a very vocal doctor, Dr Irwin Goldstein, who supports this argument and if you keep reading you might decide that for yourself - I want women to have all the information.

Now, I have no science background to speak of - I scraped through the mid-level science GCSE, but I have managed to get my head round this stuff. I once interviewed Dr Peter Bowen-Simpkins, a gynaecologist and spokesperson for the organisation Wellbeing for Women and asked him why GPs didn't fully explain the pill's workings to their patients and tended to give nonsensical platitudes. He said, 'Why wouldn't you be satisfied with just knowing it stops you producing eggs?'

The pill changes almost every bodily system. In a normal cycle huge hormonal fluctuations occur that have an impact on the whole body, right down to sense of taste and smell. The pill prevents ovulation so all the changes your monthly cycle provokes are altered. Regular hormone production is replaced by a daily dose of synthetic oestrogen and progesterone. This prevents pregnancy by shutting down the ovaries, depleting hormone production from the adrenal gland, and changing the condition of the uterus and cervix. Women are often told the pill mimics pregnancy, but the opposite is true – rather than increasing your hormone levels and fluctutations, the pill reduces and flattens them. Hence, that 'flat' feeling I spoke of earlier.

There are many brands of pill on the market, and each will have varying effects on different women. The pill that works well for your best friend, won't necessarily be right for you. And a pill that worked well for you at twenty-five might cause problems at thirty-five. Although research is dramatically lacking in this area, there are certain facts that it can help to know.

The most commonly prescribed pills are called combined, as they contain both a synthetic oestrogen and progesterone. The level of ethinylestradiol (the synthetic oestrogen) can range from 20mcg to 35mcg. A number of different progestogens (the synthetic progesterone) are used across the brands. Although your doctor will usually recommend pills that are monophasic there are also biphasic and triphasic pills which vary the levels of hormones across the monthly cycle. Also available are progesterone-only pills which have no oestrogen content.

Generally, the lower the dose of hormones, the safer the pill is for your body. Although the difference between doses in modern pills is slight, it is still recommended that the lowest dose be your first choice. Some women will experience unwanted side effects even on an ultra low dose pill, and when this occurs they can switch either to a higher dose pill or a pill containing a different progestogen.

There are two groups of progestogens – the first contains levonorgestrel and norethisterone. These progestogens act on the ethinylestradiol in the pill, and as such counter its impact on the risk of thrombosis development. These progestogens also combat problems caused by the hormone testosterone such as acne and excess hair. The pills containing these elements are progesterone-dominant.

The second group includes desogestrel, gestodene, norgestimate and drospirenone, progestogens used in oestrogen-dominant pills, so-called because the ethinylestradiol is not acted on by the progestogen. These are usually prescribed as a second choice if side effects occur with a pill containing one of the progestogens in the first group.

The progestogen-like element of the brand Dianette is an anti-androgen called cyproterone acetate specifically used for it's suppression of the androgen testosterone. This is an oestrogen-dominant pill.

Of the most popular pill brands Femodette has the lowest level of synthetic oestrogen, Femodene, Microgynon, Ovranette and Yasmin have the next highest dose, and Cilest and Dianette have the highest. Microgynon and Ovranette contain the progestogens in the first group mentioned, and as such are amongst the recommended first choice pills. All the others are in the second group as they contain the other types of progestogen.

Biphasic and triphasic pills mimic women's natural hormone cycle more closely than monophasic pills but there is no evidence this is safer or better for you. They do however produce more natural-like periods and can control more effectively bleeding patterns. Progesterone only pills are most often offered to breast feeding mothers, and women who find they are in a higher risk category for some of the pill's potential serious side effects such as thrombosis due to personal or family history, or as they grow older, or gain weight. These pills don't fully stop ovulation but act more prominently on the lining of the cervix.

Research has shown that the pill's main objective - that is stopping you getting pregnant - is actually more accurately upheld by using a condom and spermicide. Apparently, statistically, women are far better at this than taking the pill every day. Supposedly its 2 in every 100 users with perfect usage that get pregnant, and 8 in every 100 users with typical usage. Perfect usage is taking it bang on time, the same time, each day.

Back to Yasmin - I have looked more thoroughly into the science behind this one pill - it contains a particular, unique kind of progestogen which is what has caused it to produce such severe and specific side effects.

Yasmin is made up of ethinyl estradiol (that's the oestrogen part) and drospirenone (the progesterone). The drospirenone makes this pill what is called a potassium-sparing diuretic. A lot of women will have noticed needing the loo a hell of a lot more than normal when taking Yasmin. As a diuretic Yasmin causes dehydration and dehydration affects the body at a cellular level, interfering with mineral and electrolyte balances. Potassium levels to rise in the blood.

Yasmin suppresses the adrenal gland, as do all pills. The adrenal gland controls hormone production. Its suppression provokes a lowering of serum cortisol levels, which is a hormone produced to guide the body's responses to stress. Changed levels in serum cortisol are connected to depression and psychological stress. When the body experiences stress it provokes heightened adrenalin production. The long term effect of high adrenalin levels is exhaustion. Yasmin, and the pill in general, in its suppression of ovulation and the adrenal gland causes testosterone levels to drop dramatically. Testosterone plays a key role in controlling libido and mental and physical energy.

It is Yasmin's diuretic effect that accounts for the promoted weight loss, which is effectively the loss of water weight. The quashing of testosterone accounts for its clear skin benefits as it is this hormone that controls sebum (the oil in your skin) production.

So, the pill has a whole body effect, every day, for years you are taking a pill that has a extensive, insiduous effect on every bodily function.

There was an article in More magazine earlier this year that showed what days of the month you should do certain things - go to the gym, meet friends, write an essay, have a business meeting - dependent on what your hormone levels were doing at that time. This acknowledged how powerful hormones are in our lives, but I've been wondering if the article was based on the natural cycle of a woman, or on the cycle 80% of women are experiencing at any one time, that is the unnatural pill cycle.

One pill makes you larger...

2009-09-01T10:30:00.000-07:00

I have taken four different pill brands in the last decade. Each time I changed it was because I was experiencing some side effect that was definitely down to taking that kind of pill. I had migraines, nausea, flu-like symptoms, constant bleeding...Every time I had a complaint, the doctor would encourage me to try another one. I was given no explanation as to why one might work better for me than another, it never crossed my mind to ask, nor did I ever wonder if I should be on the pill at all. When I saw a doctor about Yasmin and told her it had made me miserable, or more accurately completeley insane, she said, 'I took the pill for twenty years and when I came off it, I realised I was a completely different person to who I'd thought - I had been depressed my whole life, and now I'm much much happier.'

Before Yasmin I took Cileste, Dianette and Femodette. Switching pills is a trial and error business. No one has any real idea as to why one woman might suffer from headaches, nausea, depression on Femodette, and find they dissapear when she starts taking Cileste.

There's a book by Dr John Guillebaud that contains charts which show how to make a somewhat more informed change. Basically, when you decide to switch you can either take a pill which contains a different amount of oestrogen or a pill that contains a different kind of progestogen. The effect of high oestrogen content is sort of understood - the 'first generation' pills of the 60s were very high in oestrogen and the resulting deaths have been learned from - but the different progestogens and there possible impact is a more hazy area, to put it lightly.

The first significant research into why this is all so unpredicatable was actually released only this year. A Canadian doctor, Kirsten Oinonen, has written a report entitled 'Putting a finger on potential predictors of oral contraceptive side effects' detailing her discovery. She found that measuring women's natural hormone levels of oestrogen, progesterone and testosterone can help predict whether someone will experience side effects from the pill (that is all brands). A woman's natural hormone levels can be studied easily - it's just a matter of looking at the length of her fingers and the number of hairs on her fingers. Dr Oinonen looked at side effects such as low mood, fatigue and decreased sex drive. These problems were experienced by women with what is called 'lower 2D:4D' which relates to the difference in the length of middle fingers and their having fewer hairs on those fingers.

I'll be interviewing Dr Oinonen in the next week.

64% of women between 20 and 24 are currently on the pill in the UK. Most of them have no idea what this medication does to their bodies in order to work, the medical profession has no real idea why over half of those women will suffer unendurable side effects that will cause them to stop taking the pill, or more likely switch. We keep asking, they keep prescribing.

When I was writing my feature for Easy Living the same questions kept coming up, 'Why? Why do some women get depressed and some women feel just fine?' (about 1 in 4 women suffer from depression on the pill, I'll come back to that), 'Why should it help to switch to a different brand?' 'If I get bad headaches on Cileste, which pill should I take instead?' and the only answer is

No one knows.

The pill is very under-researched. It is difficult for doctors to get the funding to carry out studies on a medication that is so widely accepted, which makes so much money for the pharmaceutical industry. It's a bit chicken and egg - the pill's popularity prevents it getting thoroughly studied.

In the UK, the pill is 'free' but in the US you'll pay around $60 a month for Yasmin. Say you take the pill for 17 years, from 16 years-old until you want a baby - that's $12000 dollars - from the 80% of women who use the pill during their lives.

The other day, in People magazine, Bayer Schering Pharma were giving away $10 off coupons.

Like candy

2009-08-31T12:21:00.000-07:00

When I got home from Asda I got to googling Yasmin. I discovered it was the most discussed pill on several forums, including askapatient.com and medications.com. The same phrases appeared over and over, 'panic attacks', 'brain fog', 'uncontrollable anger,' 'chronic fatigue' and the experiences matched up right down to the more specific details - many women reported an 'overwhelming sense of fear,' 'distrust of my partner, my family, my friends,' 'constant insecurity.' I came across a forum named 'Yasmin Survivors' that gathered news reports, and gave out recovery advice to women who claimed the effects of Yasmin had lost them their relationships, their jobs.

But I'll stop there with Yasmin - although it's the most popular pill in Europe currently - there are plenty of people taking others and I want to first place this thought in the bigger picture.

As I noted in my introduction side-bar, most women don't know what their pill contains and what those components do to their bodies in order to stop them getting pregnant. In fact, according to one study, only 15% of us have a proper grasp of this information. More and more of us are actively taking an interest in where their food comes from and what's gone into it, or where their clothes were made, by whom and at what price. But we have no idea what this medication actually does that we take, every day, frequently for decades, a medication strong enough to shut down our bodies to pregnancy.

A medication. A medication. Mull that over

Speaking of the bigger picture, where is the male pill?

The female pill was released in 1960. Every year there's a flurry of newspaper stories about the male pill being right around the corner. I've spent some time trawling through these pieces, and have noticed how the first few paragraphs are always filled with concerns and queries regarding the possible side effects of such a pill - side effects like lower libido and mood swings. These articles are generally followed with a flood of columns arguing that there's no way women would trust men to take a pill every day. As though women set the alarms of their watches, take the pill like clockwork and never, ever find themselves popping two the next morning just in case, right? We treat it so casually, of course we take it somewhat casually.

In the last near five decades the male pill has been researched extensively. The World Health Organisation has funded a six country wide study into it's possible effect on the male libido alone. The male pill hasn't even reached the market and already there's stacks of statistics on whether it'll put men off sex.

Completely understandable, of course, it's a rather cruel con to create a contraceptive that stops you wanting to do the very thing it is meant to make a whole lot more enjoyable. That's madness. So, what about us?

You can count the number of studies into the female pill and sexuality on one hand, and that research has occured entirely after its 1960 release.

When the female pill's effect on libido hit the headlines in 2005 it was a story based on the research undertaken by Dr Claudia Panzer, an endocrinologist from Denver, Colorado. She was quoted as saying she felt the pill was 'handed out like candy.' As part of my research, I tracked her down for an interview.

Testosterone is most often linked with male sexuality, but it also plays an important role in women's desire and sense of well being. Dr Panzer conducted research into the connection between the pill and women's loss of libido which showed that the pill's impact on the body reduces the amount of the 'free' testosterone. That is, the kind that effects libido and well being.

The role of testosterone has been explored in post-menopausal women with symptoms of low energy, libido, and well-being. When treated with injections of the hormone, Dr Panzer claims, they often experience 'higher sexual desire, increased frequency of orgasms, decreased stress levels, improved well being and more energy.'

Her study discovered that this effect on 'free' testosterone levels did not reverse immediately when women came off the pill. In fact, she found that the damage could be permanent.

Not to worry, the pharmaceutical company BioSanta has come up with Pill Plus -an oral contraceptive containing added testosterone and they're set to launch in 2011.

How this all got started

2009-08-30T19:01:00.001-07:00

Let's start at the beginning, why am I writing a blog about the birth control pill? More importantly why am I writing a blog that will be criticising the birth control pill? I'm not a Catholic, a silver-ring-thing enthusiast, a Christian fundamentalist or a prude. I'm not writing this to scaremonger you into abstinence. In fact, let's get the plus-points for the pill out there right now. The pill reduces the risk of ovarian and endometrial cancers. It helps with heavy and horrible periods. It prevents unwanted pregnancies. All good things. It's simple, effective and easy. Actually it's a little too easy, and not that simple, and as far as effective goes...Here's where the criticism bit comes in. As I said, let us start at the beginning.

Laura and I were sitting in the Asda car park in her silver beemer. We were there to buy leggings. Although we knew it was likely we'd come out laden, that was our story. Laura had been talking about how she'd been feeling down lately, like nothing excited her anymore. She felt directionless, bored, and very, well, blah. She'd got more excited about leggings than anything else that month - including her long term boyfriend. Her head felt like it was full of cotton wool, she couldn't think straight. She had no sex drive to speak of, but not just that, she had no drive at all. No desire to do anything, not really, not like she used to.

I said I had been feeling very similar. All my confidence and interest in life had evaporated somewhere along the way. I felt flat. Just plain empty of the varied feelings and interesting thoughts I could remember being part of my every-day a year ago.

I guess it was the sex drive bit that got us thinking. We'd read the newspaper articles linking the birth control pill to low libido. That week I had listened to an episode of the US radio show This American Life containing two stories - one about a woman who had wanted to become a man and took testosterone shots, and another about a man who suffered from an illness that rid his body of all testosterone. The latter had explained that without testosterone he wasn't only uninterested in sex, he was uninterested in life. He had no preferences, no desires, no motivation.

Laura and I were both taking Yasmin. A relatively new birth control pill at that time that had been discussed in all the magazines we read. The magazines had never before recommended one pill or another, but Yasmin was supposed to give you great skin and help you lost weight. Two very important facts to the world of women's magazines, and the women who read them. Many of our friends had deliberately asked their doctors to prescribe them Yasmin. The doctors all did so, despite it being the most expensive pill on the market. Out in the US, the pharmaceutical company Bayer Schering had launched an aggressive marketing campaign making the weight loss, acne clearing claims alongside assertions that Yasmin would stop PMS. All this hype had trickled down to the UK.

Well, our skin sure did look great, and we'd definitely lost a few pounds - but in that Asda car park Laura and I realised we no longer felt right. We figured it could be down to Yasmin.