Overprescribing the Pill

thepill

When I was in college nearly 20 years ago, most of the young women I knew took birth control pills for medical reasons as instructed by their gynecologists. Now that I am in my 30s, I am encountering women who are only just discovering that they never really needed to be on the Pill in the first place.

The friends I got to know during late-night talks when I began college were still waiting for sex until marriage, or at least waiting until they had known someone a long time. Few were yet looking for contraception, even if the RA did welcome us to the dorm with a “goody bag” of condoms. Gynecologists prescribed them oral contraceptives for a variety of health conditions: One young woman had been having her period twice a month for a number of months. Another missed them for no apparent reason. One woman had very painful periods, and another had polycystic ovarian syndrome (PCOS).

By my senior year, I too was told by a gynecologist that I needed to be on the Pill. After I went to him with concerns about PMS symptoms, he immediately suggested oral contraceptives and handed me a bag of them to take home. I never used them: Something in me questioned how easily these pills were used to treat everything. When I received a second opinion, my new doctor said bluntly, “Prescribing the Pill for your condition is like killing a flea with an elephant gun.” As it turned out, I just needed better nutrition and more B vitamins.

After a second friend of mine received a diagnosis of PCOS, her doctor told her oral contraceptives were unnecessary. This was the first time in college that I had heard of a gynecologist not prescribing the Pill for a condition.

Another friend with PCOS whom I will call “Michelle” had been prescribed the Pill since she was 16 years old. Not only was it unnecessary, but the contraceptives exacerbated more severe health problems. Having struggled for many years with debilitating depression, Michelle went to a psychiatrist who advised her to get off the Pill immediately.

When Michelle went back to her gynecologist to inform the doctor of her suicidal tendencies, her ob-gyn sighed with frustration. “How suicidal?” she asked.

That was enough for Michelle, and she stopped taking the Pill. Soon she began to feel a level of sexual desire that had been largely suppressed by the contraceptive since she started taking it at 16. With natural hormones racing through her body for the first time in years, she realized she had never had the chance to experience the normal libido that young women discover as part of their maturation process.

“My body suddenly feels like a teenage girl’s again,” she said. On this point there is no debate: Even proponents of the Pill acknowledge that it reduces a woman’s sexual drive. Therefore, millions of women spend much of their prime reproductive years never knowing the natural level of sexual feeling that is part of developing as a woman.

“I spent my 20s on the Pill and anti-depressants,” another friend recently told me. “Only after I got off the Pill and had my kids did I realize that I needed neither. I just needed dietary changes and more exercise.” Now nearly 35 and expecting her third child, she is feeling better than she has felt in years. She only regrets being prescribed the contraceptive by doctors when she was so young, which kept her from discovering and treating the root causes of her health problems.

Even when a woman eventually goes off the Pill (usually in her 30s, because of the increased risk of cardiovascular problems), her underlying health issues will remain. The contraceptive does not actually “treat” anything; it simply puts potential health issues on the backburner for a decade or two. In her recent eye-opening piece for New York Magazine, Waking Up from the Pill,” Vanessa Grigoriadis captures the effect this delay has on women’s lives in the long run:

Whatever “irregularities” a woman may have experienced in her teenage years before going on the Pill will likely be around when she goes off it. “Some women who come off the Pill in their thirties are surprised that it takes a few cycles to get their periods back, or that they may have very long cycles, or cycles without ovulation,” says Jill Blakeway, founder of acupuncture center Yinova near Union Square and a co-author of the cult book Making Babies. “The Pill didn’t create these problems: In most cases, the problems were there all the time, but because they were on the Pill, these women were never motivated to deal with them. And now they have a time issue.”

Talk to college girls today, and you will find that over-prescription of oral contraceptives continues unabated.

 

Why is the Pill so attractive to the medical community? Theories abound. It could be that many doctors, particularly those in student health clinics, do not feel they have the time to consider the variety of factors that influence women’s reproductive cycles. Or maybe an element of social engineering is at play. After all, everything from poverty to child abuse is blamed on women not taking contraceptives. Large segments of our culture push the idea that the world would be a better place if single women between the ages of 16 and 25 did not ovulate. This view is highly misogynistic, even if it is touted by groups purporting to advocate for women.

Yet many young women are still uncomfortable with the idea of using artificial hormones to avoid pregnancy. Practicing Catholic women reject the Pill for reasons of faith. For many, the idea of shutting off one’s cycle feels unnatural. As Grigoriadis notes, “Removal from one’s true biological processes was more appealing in the Mad Men era, when machines were going to save the world and pills could fix everything, even the ennui of housewives.”

By medicalizing the Pill and telling unsure young women that they must take it for their health, our secular culture can bypass a young woman’s “hang-ups” about artificial contraceptives and ensure she is on the hormones regardless of her personal beliefs.

So here is a note to young women, or any parent whose daughter will be making a trip to the gynecologist one day: The vast majority of health problems or irregularities for which the medical community prescribes the Pill can in fact be treated with alternatives such as better nutrition, stress reduction, vitamin supplementation, or natural progesterone therapy. Books such as Marilyn Shannon’s Fertility, Cycles and Nutrition and The Art of Natural Family Planning by John and Sheila Kippley detail many of these solutions.

It is important to explore these alternatives before agreeing to take oral contraceptives. When it comes to dealing with doctors and taking the Pill, young women must question the gynecological community and trust in themselves.

Elise Ehrhard

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Elise Ehrhard has written for numerous secular and Catholic publications, including The Chicago Tribune, The Washington Times, UPI, First Things, and Canticle.

  • Billy C

    Good stuff, Elise. Your piece contains an appealing mix of personal experience and religious “distance”. Be great to see it show up in as many pubs as possible, including Diocesan, college & metro newspapers, as well as alt-news pubs such as San Diego Reader.

  • Deacon Ed

    it’s just anecdotal but I remember hearing a talk some years back by Dr. Janet Smith in which she alluded to early experimental research on a contraceptive pill for men. It met with little success because men were averse to putting hormones in their body in order to be able to have sex without having the negative consequences of being burdened with those gosh-awful children that can result from sex.

    The question in my mind is why women would be so willing to put any kind of chemical or contraceptive device into their bodies. What’s even more interesting – and something I never knew – is why women would be so willing to do so at the same time that their sex drive was being dulled by the chemical. What, then, was so motivating?

  • Kathryn

    Good Deacon:

    Didn’t you know? Pregnancy is a disease state:

    http://news.yahoo.com/video/opinion-15749653/24477094

    With pregnancy comes sleepless nights, incontinence, “liver spots” on the face, stretch marks, and in 9 months, a ruined life/career.

    Men can’t get pregnant so there really isn’t a reason for them to take medication to prevent a disease they can’t get anyway.

    As for the sex drive–it’s highly overrated. At the time she’d most like to cuddle up, a woman is fertile and need to avoid pregnancy (that most dreaded of diseases) This can cause frustration and irritation. Might as well take one’s meds. Kind of a “sour grapes” thing, you know.

  • Dan Deeny

    Excellent article. Artificial contraception is a very bad idea. The other bad idea is formula milk for babies. The mother’s milk is nutritious, delicious, and inexpensive. Breast feeding makes the mother and baby serene. It transfers the mother’s immune system to the baby. Also, I found particularly interesting the fact that the nipple on the bottle allows the milk to flow more easily than the mother’s nipple. The baby has to work a little harder to get nourishment from his or her mother. Thus, the baby learns from the beginning that he or she might have to work a little to get food. How about that! Also, if I’m not mistaken, the mother is infertile while breast feeding. Thus, conjugal pleasure continues, children arrive naturally, and everyone is happy. God’s plan works best!
    Thanks again for this very interesting article.

  • Kathryn

    Mother’s milk delicious? Well…maybe if you’re a baby…

    The infertility that comes with breastfeeding is a rather elusive thing. Some women have their fertilty cut sharply; others don’t. It depends partly on how often in the nursing is done, when it is done, how old the baby. Many factors come into play. Here’s an article on the subject from CCL:

    http://ccli.org/breastfeeding/effect-on-fertility/fertility-fertility-awareness.php

    A woman who also due well to read Sheila Kippley’s book on the subject: Breastfeeding and Natural Childspacing (avail. amazon.com)

  • Donna

    Apparently researchers tried to develop a male contraceptive pill and a female contraceptive pill. The male pill caused a slight shrinkage of the sexual organs of one male in the study, and all testing on the male pill was dropped. Two women in the female group died – and the dosage was adjusted. smilies/angry.gif

    If I remember correctly, the initial testing was done in a 3rd World country. They weren’t about to do the riskiest tests in the US or Europe.

  • Mrs. F

    When I was in college–only about a decade ago–any young woman who went to the Student Health center for anything was pressured to start taking the pill. The assumption was that we were all sexually active, no matter what we said, and must therefore contracept. It was frustrating and offensive to need antibotics for a sinus infection and have the doctor or nurse insisting that we really needed the pill too.

  • Parva

    You’re telling me. My doctor wanted to put me on the pill to “regulate” my irregular cycles at 16. I refused, and I eventually “regulated” in my twenties.

    I grew up in an Evangelical family (even anti-Catholic in past generations), but this issue is one that constantly beckons me to the Catholic Church. I believe that my femininity, fertility, and matrimony are all united, that to deny me my femininity by pressuring me to use birth control is akin to suggesting my husband deny his masculinity and castrate himself. I did cave for twenty whole days to go on the pill early in my marriage, but my husband (God bless him richly!) threw the pack away when he saw how unhappy I was and the physical effects it had on me.

    It pains me that I am surrounded by women who have built their entire lives and families on fake hormones flooding their bodies–there is such a better way! And it nauseates me to meet otherwise good and sincere Christian men and women who have imbibed in the world’s view that a) children are an inconvenience which b) must be avoided by c) all forms of contraception available until d) we’re financially, emotionally, physically, psychologically, irrevocably “ready” (whatever that means). It angers me that my own pastor reproached me for refusing the drugs since that way was “the responsible thing to do”. Still, I am very careful in my social circle whenever I express such views, however mildly. Apparently, such views are judgmental, antiquated, and (horrors!) Catholic.

  • Dori

    It is normal for many young women in their teen years to have irregular cycles. Many women don’t demonstrate a regular menstrual cycle until their late teens or early twenties. “Medicating” this normal adjustment period away is not only not necessary, but interferes with the natural processes that occur in the maturation process.

    My biggest challenges in adjusting to my community practice were working in a small rural Federally Qualified Health Clinic before I converted to the Catholic Church. They particpate in a program in out state intended to provide free or low cost “family planning” services to the community. There were no abortion services (I was pro-life even then) but I saw 13 year olds who had already had 30 partners and delivered 12 year olds on a number of occasions. I treated 13 year olds for high grade pre-cancerous lesions on the cervix and was, of course, never allowed to consult their parents unless they specifically indicated it was okay. Most couldn’t understand the “informed consent” for treatment procedures, but we were expected to work around that.

    They tried, at one time, to add RU486 to the regimen and I said I would treat complications but would not prescribe or refer for it. I was made an example of and ridiculed by the medical director. I am in a different setting now. Some of my families ask me to come back in to practice, but I could never, as a Catholic, go back to that practice.

    Many of the dysfunctional elements in the community with respect to sexually transmitted infections, very young pregnancy and very early onset sexual activity, I believe to be associated with the assumption that contraceptives are the answer to every problem from acne to depression and pelvic pain to menstrual cramps. It’s time for the medical community to be reeducated but it will take a significant shift in political opinions.

  • Susan

    Absolutely! I was put on the pill at age 17, I think, for heavy, painful, irregular bleeding. I was on the pill until after I was married. I was honestly scared to go off it because I didn’t want to go through that again, and I figured my doctors (who were Catholic) wouldn’t have put me on it unless it were truly necessary. Well, about a year after I was married I was fed up, and I’d been doing research about alternative treatments, so I went off. Took only one month of charting to realise that I bled at ovulation and menstruation, something that is perfectly normal and is actually quite common in teens. Only by that time I was in my mid-20s, and it was still present since it had never been addressed. For me, that ended after having my first child. I really wish I’d known enough to question my doctor earlier, though. I still get angry about it, and I really struggle not to harbour resentment towards the doctors.

  • Catalina

    I recently went to the gynecologist’s office. She was a kind and friendly woman, but she mentioned the pill almost immediately after hearing that I bleed heavily during my periods. When I told her that I couldn’t take it for religious reasons and that I believe it to be an abortifacient, she said that was a myth. (Although I know that at least some versions of the pill work to prevent implantation or make it more difficult, I decided not to bother arguing with her.) I was rather offended by her disregard of my beliefs and doubt that I will return there. It’s very difficult, though, to find a gynecologist who hasn’t drunk the contraceptive Kool-Aid.

  • Dan Deeny

    Kathryn,
    Thanks for your response. I got my info. from Milk, Money, and Madness, The Culture and Politics of Breastfeeding by Dr. Noemi Baumslag. An interesting book.
    I’ll look at the info. you provided. I have a book by John Kippley, Sex and the Marriage Covenant. Not very interesting for me. Wordy. JP II seems much better. I’ll look at Sheila Kippley’s book. But Natural Family Planning doesn’t seem natural.
    Sure, just ask any baby!
    The ladies’ comments are very interesting. Women must handle real world problems.

  • Kathryn

    @ Catalina: All formulations of the Pill are potentially abortafacient in that they all cause changes to the endometrium that inhibit the implantation of any embryo (it’s an embryo at that point–having ceased to be a “feriltized egg” several days before) The same thing that makes them abortafacient is the same reason they are prescribed for heavy periods–they prevent a “lush” endometrial lining from forming, making it relatively thin. The thin lining, then, results in a lighter period.

    You might check out M. Shannon’s book Fertility, Cycles, and Nutrition for nutrional info that might help reduce significant periods. Should be available on both http://www.amazon.com and at http://www.ccli.org

    @ Dan: Yeah, I think I have that book in storage somewhere. I bring up Sheila Kippley’s book because a number of people think “Oh, I just need to breastfeed and I’ll be infertile. Cool!” It doesn’t work like that. A specific set of circumstances need to happen in order to get the two to three years of child spacing people seem think is optimal. Then of course, people are horrified that they become pregnant while breastfeeding and claim it doesn’t work.

    “Natural Family Planning” really ought to be called the “Fertility Awareness Method”, except that there already is an “FMA” method and it accepts the use of barrier methods during the fertile type and NFP doesn’t.

  • Deacon Ed

    database of contraceptive/abortion – free OB/GYN doctors for Catholic women and others of conscience to chose from.

    If the Bishops of the USA wnated to make good use of the money the poor slobs in the pews send them for “social justice” it would earmark some money solely for this use.

    When I was Director of Catholic Charities for my diocese, I allocated some money available to us for the development of such a database but because the money was given to another department in the diocesan structure, I had little control over whether it was actually done (it was not).

    Someone here want an important Church ministry to take on?

  • Mrs. F

    One of the best things about NFP is the awareness it gives me about my own cycles and what is normal for my body. We haven’t actively practiced it recently since I’ve been either pregnant, ecologically breastfeeding or pregnant again (and again) for the past five years, but the awareness it gives has also help me in body awareness during pregnancy. Before having children I had such painful and severe bleeding during cycles that I though I had endometriosis, which several other women in my family have also had. Charting helped me to take the vitamins and anti-inflammatories for a few days prior to my period, which helped keep the pain down. I was also able to notice and counteract moodswings that came with my cycles, adjust eating habits for the different hormonal times, etc. It’s complicated, and women who have been on the pill for most of their fetile life may never know what is normal for them.

    I have a hard time imagining that forcing artificial hormones on the body for years, even decades, does not have some sort of detrimental effect. Some people say the couldn’t imagine having to abstain from marital relations for certain times, but most of the women I know who contracept (either with the pill or when one spouse has been sterilized) have many, many more complaints about their intimate lives than my husband and I, or other families I know who don’t contracept.

  • Kathryn

    Yours is a reasonable idea and has been by such organizations as One More Soul (http://onemoresoul.com/nfp-directory) and by some guilds of the CMA.

    Alas, in the one CMA guild website that I logged on to, it listed this one physician as working as accepting all the moral teachings of the Church. I know a nurse in his practice, as was assured by the nurse he perscribes contraception. No list is perfect.

  • Katie @ Wellness Mama

    Well said! Thanks for getting this out there. With my work in nutrition, I see all the time the drastic improvements women see from changing diet and lifestyle factors, and I’ve worked with a lot of women specifically in the aftermath of the pill. It is sad what it does to the normal healthy functioning of a woman’s body. Things like PCOS, endometriosis, cramps, PMS, heavy bleeding, etc are signs of a deeper problem in the body, and are certainly not caused by a deficiency in contraceptives!
    It is also heartbreaking to me to see the women who are working to improve fertility after years on the pill. It can usually be done, but is a long process because of the negative effect of the artificial hormones.

  • Tina

    and acne-caused depression!

  • Tina

    All women who are honest with themselves have experienced dramatic cycle changes because of unavoidable stresses. This is how they get pregnant during their “infertile” periods. Today’s pill has much lower estrogen levels and most users are satisfied with its many benefits. Its invention was inspired by nature’s many high estrogen plants like yams and yuccas.

  • Jeanne G.

    If women who use NFP properly have changes in their cycles, they will notice that there has been a change and proceed with caution, rather than blindly believing that there won’t be any effect on fertility.

  • Therese

    I’m surprised no one mentioned one of the more compelling reasons for not taking the pill as a teenager or before carrying a pregnancy to term – the greatly increased risk of developing breast cancer. Yes, it is documented in over 30 studies. Due to the undeveloped breast tissue, added estrogen has a carcinogenic effect though it can take years to develop. For an anecdotal approach, one has only to look at data comparing the rise in breast cancer to the rise in oral contraceptive use and then take it from there.

  • Maggie

    Yes the first contraceptive pill was designed for men but because of the side effects they decided to torture women with it. There is a scientifically based way both achieve or avoid pregnancy that is church acceptable and can be used to diagnose and treat issues such as PCOS, PMS, and PMD. That is Creighton Fertility Care system in conjunction with a dotor that is thouroughly trained in NaProTechnology. There is a great book about it you can get on Amazon called The NaProTechnology Revolution Unleashing the Power in a Woman’s Cycle. You can also check out their web sites etc. Couples having trouble conceiving have had better and might I ad less expensive success with this than all the expensive artificial nonsense those other doctors offer. When the pill became popular the field of OB/GYN stopped treating causes and curing problems and went to treating symptoms by suppressing a woman’s natural fertility. Hormones are a delicate balance and research has shown that the pill icreases the woman’s chances of breast cancer and other cancers. It is the cause of infertility in many women. There is help available. We need to demand change from the medical profession. We need them to hear us and treat us instead of trying to destroy us.

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