Female Hormonal Therapy Warnings Go Unheeded
Camilla Gunnarson

Many in the Pro-life movement have been warning women of the dangers of the birth control pill for over forty years. The warnings have been largely ignored, not because they're not scientifically sound but quite frankly because they've come from us. After all, if prolifers are telling women that the Pill is dangerous to their health and happiness, it is simply seen as fear mongering and moralizing.

Does the Pill Prevent Abortion?

The Pill was introduced over 40 years ago with the expectation that it would allow women to control reproduction and lead to a decrease in unwanted pregnancies. (Although abortion was not legal in Canada at the time, there were doctors performing illegal abortions.) The reality is contraception use does not always prevent pregnancy. Several studies indicate that contraceptive use increases pregnancy and abortion rates. A study published the British Medical Journal in August 2000, revealed that teens who consult with health care professionals about contraception actually have a higher rate of pregnancy (as much as 11 to 15 percent higher) than those who don't. Another study showed that "over 80 percent of young women who have had abortions are contraceptively experienced." According to the Alan Guttmacher Institute, Planned Parenthoods's research arm, "over half of women having abortions say they were using a contraceptive in the month they became pregnant."

How does the Pill Work?

Doctors generally do not inform women who use the Pill how it actually works. The Pill (combined and mini), Norplant, Depo-Provera and the morning-after pill (MAP) which is also called emergency contraception, allhave similar properties. The primary action of these hormonal contraceptives is to suppress ovulation and to make the cervical mucus inhospitable to sperm. But according to medical journals, textbooks and even pill manufacturers, a secondary effect is to thin the lining of the uterus. In other words, breakthrough ovulation (that is, the suppression of ovulation fails and an egg is released) can occur and can result in fertilization. In other words, the newly conceived embryo cannot implant within the altered lining of the womb. Without the mother's knowledge, about six days after conception, the embryo is chemically aborted. The failure to disclose to a woman that a drug could induce the death of her newly conceived child constitutes lack of informed consent.

Clearly many women and even more physicians do not share this view of the Pill. They see it as an acceptable way to “fool” the body and allow women to decide when they will have children. In its early years the Pill was regarded as one of man's greatest achievements. Anthropologist and sociobiologist, Ashley Montagu, said the following in 1969, barely a decade after the Pill came into general use:

"The Pill! The fact that it is referred to so majestically represents something of the measure of importance that is generally attached to this genuinely revolutionary development. For it is a revolutionary development, probably, to be ranked among the half dozen or so major innovations in man's two or more million years of history. In its effects I believe that the Pill ranks in importance with the discovery of fire, the creation and employment of tools, the development of hunting, the invention of agriculture, the development of urbanism, scientific medicine, and the release and control of nuclear energy."

After almost half a century of experience, however, there is increasing scientific evidence that this attempt to circumvent biology has in fact fooled (in a not very amusing way) women and created a host of health problems that most users are still unaware of.

That is beginning to change. 2006 had barely begun and media headlines highlighted a US study in the Journal of Sexual Medicine that said the Pill may destroy the sex drive in some women. This of course is no surprise to prolifers; we have been saying that for years. Loss of libido is a common, but seldom publicized side effect of taking the Pill. However, lead author of the study, Irwin Goldstein, suggested that new research indicates there could be "long-lasting consequence of taking the Pill." Until now, most physicians assumed a woman's hormones return to normal once she stops taking the drug. This is the first study to find that the effect could linger for months, possibly years, after a woman goes off the Pill.

If that isn't enough to dissuade any woman who is concerned for her health and welfare, consider Dr. Goldstein’s comments: "I guess you pick and choose your poisons as you go through life. You want contraception, so you give up these other things. But nobody [until the current study was done] realized there were more chronic consequences from taking the Pill. This will at least alleviate the pain in their wallet." Goldstein's shocking statement illustrates the complete disregard some in the medical field have for women's health.

How is it that so many women have agreed unquestioningly to ingest this "poison?"

Hormonal drugs of various types have become commonplace in the lives of women. It is estimated that more than 100 million women - about 10% of all women of reproductive age – currently use combined hormonal contraceptives (roughly 1.5 million in Canada).  It is true that all medications have some negative consequence, but never in the history of modern medicine has such a potent drug been promoted and accepted as the norm around the world.

Development of hormonal drugs

Despite its widespread use, few women understand the biological and pharmacological makeup and mode of action of hormonal drugs. Scientists discovered estrogen and progesterone during the late 1920s and early 1930s and began to study how these two hormones affected fertility. This led them to develop synthetic hormones to produce a constant state of infertility. The progesterone that was available had to be administered in large doses, did not completely suppress ovulation and was too expensive, so several scientists began to search for an inexpensive source in the 1950s. Dr. Carl Djerassi, a young scientist, capitalized on the research of Russell Marker in extracting progesterone from Mexican yams, and succeeded in 1951 in synthesizing a form of progesterone (now called progestin) that was four to eight times more powerful than the natural hormone.  This new oral contraceptive pill consisted of a number of synthetic progestins and one to two estrogen analogs. It had serious and sometimes fatal side effects, including cerebral and coronary thrombosis and thrombophlebitis, which could lead to a fatal pulmonary embolism. Drug companies began research to develop hormonal contraceptive with fewer side effects. Since the estrogen was identified as the cause of many of the adverse side effects, the level was reduced.

Today, scientists have created various preparations using synthetic hormones that alter the natural physiological characteristics of a woman's endocrine system. These include the combined progesterone-estrogen pill, the progesterone-only 'min-pill', DeproProvera, Norplant (progestin-only), the morning-after pill (MAP), and Hormone Replacement Therapy (HRT). These drugs are not all the same, but since all female hormonal therapies contain similar components, it is biologically and pharmacologically plausible to expect similar risks.

What are the risks?

Women who use any of these hormonal therapies have an increased risk, three to 11 times greater, of developing blood clots that those who do not. Blood clots can cause strokes, heart attacks, pulmonary embolism or blindness.

According to the American Journal of Gynecology (1990), "the risk of fatal heart attacks is approximately twice as great among users of the current lowdose Pill compared to non-users. The risk of a fatal brain hemorrhage is 1.4 times higher among Pill users than among non-users. Among women who smoke, Pill users have a 12-fold increase
in fatal heart attacks and a 3.1- fold increase in fatal brain hemorrhage."

In the fall of 2004 Kathleen Thoren, mother of three, died after days of agonizing headaches that the coroner's report said were brought on by hormones released into her system by Ortho Evra, a birth control patch she had been using for several weeks. She was among about a dozen women, most in their late teens and early 20s, who died from blood clots believed to be related to the birth control patch.

The women who died were young and apparently at low risk for clots. Women like Zakiya Kennedy, an 18-year-old Manhattan fashion student, who collapsed and died in a New York subway station last April. Or Sasha Webber, a 25-year-old mother of two from Baychester, N.Y., who died of a heart attack after six weeks on the patch last March.

Dozens more survived strokes and other clot-related problems, according to federal drug safety reports obtained by the Associated Press under a Freedom of Information Act request.

Several lawsuits have already been filed by families of women who died or suffered blood clots while using the patch in the United States. Lawyers confirm more lawsuits are planned.

Last July, Health Canada and Pfizer Canada Inc., the makers of the birth control shot Depo-Provera, warned Canadian women that the injections may cause significant bone density loss and advised that it should be used for the shortest period possible. Loss of bone density can increase the risk of the brittle bone disease osteoporosis, as well as hip, wrist and other bone fractures, especially after menopause.

Furthermore, a division of the World Health Organization (WHO), the International Agency for Research on Cancer (IARC), issued a warning last July. The IARC declared combined estrogenprogestin oral contraceptives (OCs) as carcinogenic to humans. According to the report, women have an increased risk of breast, cervical, and liver cancer. This is of enormous public health importance since according to the IARC "worldwide, more than 100 million women - about 10% of all women of reproductive age - currently use combined hormonal contraceptives." Despite this admission, the WHO has not discouraged use of the drug. However, the re-classification of the Pill has precipitated the Canadian Cancer Society to conduct a review of its position on oral contraceptives. That review was highlighted by breast cancer survivor and popular CBC personality Wendy Mesley in a TV special this winter.

Commenting on the exposure to the hormones estrogen and progestin foundin the Pill, Dr. Sam Epstein, author of Cancer-Gate: How to Win the Losing Cancer War and Professor of Environ mental and Occupational Medicine at the School of Public Health, University of Illinois at Chicago, told the CBC’s Marketplace that, the Pill is “the largest unregulated human trial that’s ever been conducted."

It is interesting to note that many municipalities throughout the country are enforcing pesticide bans. But according to an article printed in Scientific American in which several activitieswere ranked according to their contribution to the number of annual deaths in the United States, oral contraceptives were listed ahead of pesticides.

In 2002, the Society of Obstetricians and Gynecologists of Canada (SOGC) warned women about the dangers of hormone replacement therapy (HRT) after a study revealed an increased risk of heart disease, stroke, blood clots and breast cancer among HRT users. The estrogen dose for post-menopausal HRT is substantially less than that in the Pill. One birth control pill is equiva lent to two to four HRT tablets. Since the SOGC's warnings in 2002, sales of HRT in Canada plummeted from 12.6 million in 2001 to just under 5.9 million in 2005.

In what some saw as a surprise announcement, the SOGC rewrote its guidelines on the use of HRT this past February. The 2006 Menopause Consensus Report recommends health care professionals offer hormone therapy as the most effective option for moderate to severe menopausal symptoms. The recommendations urge that the drug be prescribed at the lowest effective dosage for the "appropriate duration" and that extended periods of HRT should only be prescribed after proper counseling about the benefits and risks with periodic evaluations recommended. But, according to menopause specialist, Dr. Sheldon Frank of Waterloo, Ontario, the new guidelines don't discount the 2002 findings. "The guidelines aren't a departure from the stand the society took after the 2002 study results. I don't think they're saying anything they haven't been saying for the past four or five years."

The MAP or the emergency contraceptive pill (ECP) is generally marketed to teenagers who may have had "unprotected sex" and is now available in Canada without a prescription and without parental notification. MAP consists of two megadoses of the Pill. Children as young as 10 have received this drug. Given what we know about the dangers of other hormone therapies, shouldn't we also be warning young women of the dangers of MAP?

Stop Exploiting Women's Health

The long held view that hormonal therapies cause little or no adverse sideeffects on women's health is archaic. Sadly, women know little about these drugs, their mode of operation and their long-term health effects. There has been serious neglect on the part of the medical profession and the pharmaceutical industry in informing women of all of the consequences of hormonal drugs. More than 100 million women will use combined hormonal contraceptives this year and they will likely do so without having all the information needed to make good choices for themselves. How long will the medical profession and pharmaceutical industry continue to run roughshod over women's health? Those who champion the Pill as a necessity for women, do so behind words as such as "freedom" and "health.” We are now discovering that women who use the Pill have been denied both.

Camilla Gunnarson is a part-time editor of LifeCanada News.