Tuesday, 19 November 2013

Why are we all on 'The Pill'?

100 million women worldwide currently use oral contraceptives (OC). With so many of us being put on ‘the pill’ as standard when we become sexually active and often continuing for 10,15,20(+?) years without questioning this, I have often wondered whether if we stop and think about it – Is this actually OK?  Yes, a reliable contraceptive method is without doubt essential. But interfering with our natural hormone levels, cycles, fertility, moods... I have to say seems like we are being almost sexist to ourselves. If you argue that it is a woman’s choice, I propose that if you offered the average woman a suitable alternative or an equally effective male alternative they would take it. With recent research linking long-term pill use to glaucoma I again question whether we can really anticipate all the future implications of interrupting our natural regulatory mechanisms and processes. Oestrogen and progesterone are anything but simple biochemicals.

Research has for some time been debating the possible link of the pill and increased or decreased risk to particular cancers. However, it is the effect on everyday living that is arguably equally if not more important. Removal of ovulation and the natural changes in hormone levels throughout the cycle can leave women feeling emotionally numb and often depressed. It’s hard to know when you are having a low period or being truly yourself or whether the pill is really affecting quality of life. Research into the pill and depression is limited; however there is suggestion that increased levels of oestrogen and progesterone (as in the POP) can cause lower levels of serotonin, the happy hormone.  On discussion with friends we have all changed brand of OC at least once over worries that our mood has been lowered by a particular pill and on reflection should have asked whether we should be on it at all. I have had a year here and there where I have decided on a break when fear of this and other serious health links (deep vein thrombosis, stroke, heart attack, cervical/liver/breast cancer) have played on my mind too much. Reasons for going back on, aside from convenience as a contraceptive method have been the positive effects on balancing out PMS, acne, period pains and hormone-related IBS as well as the ability to control when you do or do not have a period for holidays.  Attractive benefits, but most with realistic non-hormone related alternatives.

As reports of pill use for 3+years doubling risk of glaucoma currently in the press I have investigated other recent research into oral contraceptives. An Austrian study in Brain Research this month suggests that OC use may have profound effects on cognition. They detected a masculinisation of brain responses in women on the pill compared to women having natural menstrual cycles, as detected by fMRI responses to numerical tasks. Effectively, the progesterone levels caused by OC use are resulting in our brains becoming more like men than women. On top of this a German study has found that our brains respond more to money as an attractive trait in a partner when on the pill than when allowing a natural cycle, when we favour genetic benefit at times when we are most fertile. So being on the pill may be even influencing our choice of partner.

The pill is also affecting men, both directly and indirectly. With widespread speculation that oestrogen in our drinking water (from the vast quantity that is excreted in our urine) is resulting in feminisation of the male population, question over long-term effects on fertility have also arisen. Further research has shown that when women follow a natural cycle, their male partners find them more attractive around the time of ovulation compared to the luteal cycle phase. As ovulation is removed when on the pill this removes this effect and also results in the men rating themselves as feeling less attractive when the woman is on the pill. It is notable however, that there was no difference in female self-reported attractiveness.  

At a time when there is a dearth in contraceptive methods that bear the convenience and non-invasiveness of the pill it is difficult to suggest re-thinking this approach. However I do hope that research continues into this area and that further discoveries of the effect of the long-term hormone disruption on other bodily systems do not emerge. As risk of DVT does increase with age I would really reconsider staying with the pill after 35 and also to be honest about smoking as this is also a big risk factor. There is also the suggestion to look further into the different types of contraceptive pill and their reported side effects and finding the one that seems most suited to you, rather than relying on your GP to fully make the decision.

#thepill #oralcontraceptives #glaucoma #oestrogen #progesterone #contraception #hormones #the pill

by Rachel Brophy

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