As
barriers get broken down we have still to come to terms with the full effects of
the biological pathways traveled by the contraceptive pill. Progesterone was
chosen in the early 20th century because even then, the carcinogenic
properties of estrogen although miscalculated, had been recognized. But what are
the overall implications when the entire endocrine system is disrupted?
A
case recently brought in front of the British High Court might not change
desires very much, but it might bring the issue back into the public arena. The
claim of over 100 women involves Organon Laboratories, Schering Healthcare and
Wyeth. The legal action concerns the contraceptive pill. Filed under the
Consumer Protection Act, the argument is that ‘the pill’ is unsafe and
further research should have been carried out before the third generation pill
was introduced in the early ‘80s. Representing lawyer Martyn Day informed the
media, “We now know that these third generation pills double the risk of women
for developing dangerous blood clots.” Naturally, the manufacturers argue that
the third generation pill is safe and that the legal action is unfounded (PA
p.1).
Health
Issues Cause Pill Scare
After
the 1995 pill scare, British women’s use of the pill had dropped sharply and
so did the incidence of venous thromboembolism among oral contraceptive users.
The clotting of blood mainly in the calves causes red, swollen and painful legs. The blood clot travels in the bloodstream resulting in what is known as venous
thromboembolism. A clot can lodge in the lungs causing pulmonary embolism
resulting in breathlessness, sharp pains in the chest and possible collapse (mca
p.1).
Venous
thromboembolism can also occur as a result of pregnancy, which is the argument
used by the British Health Ministry and others to placate the issue. In response
to the scare, the Ministry of Health issued a press statement and sent letters
to general practitioners and pharmacists highlighting the ‘possible
increased’ risk of venous thromboembolism due to low dose oral contraceptives.
These
contraceptives contain synthetic desogestrel or gestodene –third- generation
oral contraceptives. Women were to be made aware of the risks yet at the same
time to be advised that there was no need to change from ‘existing choices’.
This
response was based on five studies made in December ’95 – January ’96. All
those studies had confirmed that third-generation oral contraceptives double the
risk of venous thromboembolism (Medsafe p.1). The European medicine regulators
and The Committee for Proprietary Medicinal Products concluded that women on the
third-generation combined oral contraceptives Femodene, Femoden ED, Femodette,
Marvelon, Mercilon, Minulet, Triadene and Tri-Minulet are only at a slightly
higher risk of developing venous thromboembolism than those who used second
generation pills, progestagen and levonorgestrel. The U.K authorities concluded
their delegations on the issue in 1999 and supplied information for leaflets
placed in pill packets. They emphasized no need for women to discontinue the
pill (Hollander p.3). The Department of Health also supported this and
emphasized, “THAT THERE IS NO RISK.” (Dott p.3)
A
further refined analysis confirmed that third-generation contraceptives
containing progestagen, desogestrel or gestodene are linked to the higher risk
of venous thromboembolism. The study also confirmed a risk with
second-generation levonorgestrel. Using the British General Practice Research
Database, women aged 15-39 who had received pill prescriptions from January
’93 – December ’99 were identified. This study included the period leading
up to the pill-scare and the period immediately after. Before the scare, 63% of
oral contraceptives used were third-generation. After the scare, it had dropped
to 18%. In the study, 106 women had developed venous thromboembolism. Of these,
42 used levonorgestrel and 63 used third-generation contraceptives. During both
periods, the incidence of venous thromboembolism was higher for women who used
the third-generation pill (equating to 37-41 cases per 100,000) relative to
second-generation levonorgestrel (equating to 20-23 per 100,000). This was
reflected in the significant corresponding fall in cases after 1995 along with
the decreased level of users (Hollander p.2). The risk factors identified in the
World Health Organization’s collaborative study on cardiovascular disease and
steroid hormone contraceptives included: a) body weight over 25kg/m², b) a
history of hypertension in pregnancy, c) a history of varicose veins and c) the
presence of rheumatic heart disease (Medsafe p.2).
However,
venous thromboembolism only represents the most evident aspect of contraceptive
use.
Aging
Effects of the Pill
Feminist
Germaine Greer had argued against the widespread distribution of oral
contraceptives in developing countries by foreign benefactors. Whether in
developed or developing nations, the
problem
still applies. “While it is still painfully obvious that our youngest women
need contraceptive protection, it seems hardly less obvious that sex steroids
are the wrong protection. We cannot afford to trivialize a medication as
mysterious and powerful as the contraceptive steroid. If some delayed
consequence of its action should make its appearance sometime in the next 20 or
30 years we want to have some chance of tracking down those of our children who
are at risk (Greer p.147).”
An
expert in this field, Professor Erik Odeblad of the Department of Medical
Biophysics at the University of Umea in Sweden has been studying the cervix for
over 40 years (Odeblad p.1). He discovered the different types and properties of
the cervical secretions including G, L, and S-Mucus in the late ‘50s and the
P-Mucus in the late ‘80s. The P-Mucus causes the wet-sensation that a woman
feels on her peak fertility day. The mucus-producing cells atrophy as a result
of contraceptives therefore reducing fertility (Odeblad p.1).
Under
healthy circumstances, pregnancy counteracts the normal aging process and
rejuvenates the cervix. The cervix of a 33-year old woman becomes that of a
20-year old. Long-term use of the pill reverses this effect and the cervix of a
33-year old woman becomes that of a 45-year old. The cervical canal becomes
narrower. The third-generation gestodene pill has a similar effect. Lower dose
progestagens are in fact more powerful and persist longer in the body. Like all
oral contraceptives, the lower dose pills’ primary purpose is to sterilize by
inhibiting the hypothalamic-pituitary axis, critical to human endocrine
function. The secondary function is to stimulate G-Mucus secretory cells. This
creates a contraceptive barrier to the sperm. Normally, G-Mucus secretion takes
place in the stomach and the duodenum. Responsible for the production of gastrin
in the stomach, G-Mucus stimulates the release of gastric hydrochloric acid and
pepsin for digestion.
Progestagen,
whether combined or alone as in the mini-pill, has the same action as the
‘morning after pill’, preventing implantation of the embryo, leaving it
nowhere to go if conception occurs resulting in abortion (Odeblad & Hume p1,
2). Contraceptives affect mucus production, and the producing cells as a result
atrophy, changing the biochemistry of the cervix and reducing fertility (Odeblad
p.1).
There
are also very strong signs that men could also be affected. A recent study
carried out by the British Environment Agency examined 10 lowland rivers over a
five-year period. As a result of estrogen in urine from the contraceptive pill
passing through the sewage works, they found 50% of male fish had developed eggs
in their testes and many cases had developed female reproductive ducts. This has
been linked to the human population’s dramatic fall in sperm count (Lean p.1,
2).
What
Lies Ahead?
After
the ’95 pill scare women either changed their pill type or stopped altogether.
The 8% rise in abortions may have been affected by other factors like the
worsening social and economic climate in Britain (BBC p.1, 2).
Now
a new pill is on clinical trial in the U.S. The aim is to get a woman to
menstruate only 3-4 times annually. Called ‘Seasonale’, this pill is
licensed by Barr Laboratories from the Eastern Virginia Medical School that
patented the concept. Unsubstantiated ideas don’t necessarily shed light on
the matter. “It might be that if you retain the eggs, the quality (later
on) might be better. The window of fertility could be held back”, said Roger
Gosden, scientific director of the Jones Institute of Eastern Virginia Medical
School.
Others
have gone on ahead like Professor John Gulleband, an independent gynecologist
and medical director at the Margaret Pyke health center in London. He prescribes
the pill for women who experience period cramps, headaches and delayed
menstruation. “It doesn’t seem to have a long-term effect on the ovaries or
pituitary gland. Those are effectively put to sleep the same as when a woman is
pregnant. Then they bounce back (Charles p.1).”
Islam
has prepared us for what we cannot foresee and is not against the prevention of
conception but is against infanticide. If politics doesn’t get in the way of
the British women’s legal claim, one prays that more honest and long-term
research is carried out. Look not to the instant benefits but to the
consequences on the long-term health of women and their offspring. In many
cases, the pattern of disease is set into motion by the changing external and
internal environment. The cervix, one of the most complex organs of the body,
can be damaged by exposure to toxic substances including the synthetic hormones
of the pill. If there are women who want to make that choice, allow that choice
to be an informed one.
Sources:
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