Pill’s pitfalls create ‘contraceptive conundrum’

“The pill is the only drug that was developed to be given to a woman who was healthy to create a diseased state.”

Dr. Marguerite Duane, a family physician and professor at Georgetown University School of Medicine, describes perfectly the contradiction — the conundrum — that has existed since the advent of the modern oral contraceptive — the pill — some six decades ago.

Oral contraception is almost universally prescribed today, despite the fact that its dangers are now indisputable. The World Health Organization places the estrogen-progestogen pill on its list of Group 1 carcinogens, the most toxic rating it can impose, even as governments, international agencies and pharmaceutical companies push countries across the globe to embrace a contraceptive culture.

Many physicians, pharmacists and biologists have warned about the risks to women’s health posed by oral contraceptives, but their concerns have been ignored or suppressed by groups determined to use the pill as a tool of ideology, money and power.

One of the greatest surprises, for example, is that while it is one of the most heavily prescribed drugs in the world, oral contraceptives have almost never been the subject of medical and research experts coming together to discuss what exactly contraceptives do to the human body — most so women’s bodies. That fact alone made the research symposium entitled “Contraceptive Conundrum,” held in conjunction with the Edmund D. Pellegrino Center for Clinical Bioethics at Georgetown University on Aug. 8, so remarkable. As Dr. Kevin Donovan, director of the Georgetown Bioethics Center, said at the opening of the symposium, part of the goal of hearing from first-class researchers on oral contraceptives was to correct this massive gap in scientific inquiry.

Health hazards

There are, of course, profound moral questions pertaining to the use of contraception, but there is also an obligation to encourage the scientific and medical community to grapple with the mounting evidence of the impact of the pill on health.

Hormonal contraceptives are tied to lupus, inflammatory bowel disease, reduced immunity, increased susceptibility to sexually transmitted diseases and blood clots. Even more alarming are the documented medical realities that women who take oral contraceptives face, as they are twice as likely to develop cervical cancer and 10 to 30 percent more likely to develop breast cancer than women who never took the pill, a risk that lasts for more than a decade after a woman ceases to use the drugs.

The many disturbing risks were detailed at the start of the symposium by Dr. Chandler Marrs, who wrote a report, “Birth Control, Big Money and Bad Medicine: a Deadly Trifecta for Women’s Health.” A noted research scientist, writer and women’s health advocate, Marrs argued that “we underestimate the risks of synthetic hormones by ignoring the vast reach hormones have on health.” And yet, as her talk documented, the vast majority of women between the ages of 25-44 are prescribed contraceptives by their physicians as a panacea for virtually every health problem even though the pill does not actually treat most of those conditions. Prescribing contraception for such a wide variety of medical issues makes, she says, no pharmacological sense, but she spoke convincingly about the dominance of the pharmaceutical industry in encouraging the world-wide distribution of the pill without detailing its many side effects.

Duane, who helped introduce the conference, added that the pharmaceutical industry wields immense influence in the education of doctors.

“The pill,” Duane said, “for many is a sacred cow, and you do not dare in any way desecrate the importance of birth control and the role it has played in women’s health. And as such, many physicians are reluctant to learn about this information, to talk about this information.”

Serious side effects

The influence of the pharmaceutical industry in promoting oral contraceptives becomes even starker in the face of recent lawsuits. Pharmaceutical giant Merck agreed to pay $100 million to 3,800 claimants who argued that the contraceptive NuvaRing can induce heart attacks, blood clots and strokes. Similarly, Bayer paid out a settlement of $1.6 billion over the potentially dangerous side effects caused by the contraceptive Yaz/Yasmin, including 7,660 claims regarding blood clots and another 8,800 claims involving gallbladder damage.

Moving beyond the dangers of cancer, blood clots and other illnesses, pharmacologist Dr. Ross Pelton spoke on “The Pill Problem: Nutritional Issues,” examining the highly documented hazards of nutrient depletions through the use of oral contraceptives.

Hazards to unborn children from contraceptives were also detailed by the neuroscientist and biologist Frederick Vom Saal, in the presentation “Getting pregnant while on oral contraceptives: Likelihood of adverse effects on fetuses.” Other topics ranged from “Evidence for effects of hormonal contraception on partner choice and relationship satisfaction,” the “Neuroscience of Libido: Lessons Learned from Oral Contraceptive Use” and “What does the pill do to the brain?”

Healthy alternative

As recognized experts in the fields of biology, medicine, neurology, pharmacology, physiology and neuroendocrinology talked to each other and presented advanced technical reports, it became clear that there is a severe need for further comprehensive research into the impact of contraception.

What is equally clear is that far from liberating women, the pill has placed them at severe risk of illness and even death, damaged their nutritional health, altered the very biology of how men and women relate to each other, and endangered the health of their future children. The conference was an important step toward correcting a failure of scientific review.

And as growing numbers in the medical and scientific community provide serious research into the effects of the pill, proven medical and health alternatives assume greater urgency.

One path ahead is the Fertility Appreciation Collaborative (FACTS), co-founded in 2010 by Duane and Dr. Bob Motley, comprised of physicians, other health care professionals and educators working together to teach the science of natural or fertility awareness based methods (FABMs), traditionally called natural family planning (see sidebar).

These methods can be used to address a wide range of women’s health issues, but they might also spark a genuine movement away from a contraceptive culture.

“Our society over the last 50 years has really changed its approach to fertility with the advent of the pill,” Duane said. “The vision of FACTS is to change the culture of medicine so that fertility is once again seen as something that is normal and healthy.”

Matthew Bunson is OSV’s senior correspondent.