Politics and the President's Pill. Are They Healthy for Women?
Announcing that insurance companies would pay for contraceptives on Friday, President Obama added that doctors "put women on contraceptives as a way to prevent and reduce the risk of ovarian and other cancers." Days earlier, Nancy Pelosi said that peoples' complaints about the contraceptive mandate and religious freedom were not the issue and emphasized that "this is about women's health."
There is an issue, though, regarding the mandate that lies beyond the grave religious and constitutional issues therein: do contraceptives harm women's health?
"Reproductive justice," closely allied to "social justice," is a term coined by women at the International Conference on Population and Development in Cairo in 1994. The term embraces reproductive rights, reproductive health, and of course reproductive justice. NOW, NARAL, Emily's List, Planned Parenthood, and others who subscribe to this ideology have applauded Obama's decision to make contraception available to all women "free of charge."
So in the interest of women's "reproductive health," what should women know about contraception?
Carl Djerassi, known as the "father of the pill," developed the first orally active progestational substance, called norethindrone, in 1951. Shortly after, Gregory Pincus of the Worcester Institute tested these compounds; he was supported by Margaret Sanger and her financial backer, Katherine McCormick, who was the heir to the International Harvester fortune.
Then, in 1954, John Rock, a renowned gynecologist, began the first human trials of the oral contraceptive norethinodrel. Finding suitable women for the trials was difficult; McCormick complained that the real problem was how to get a "'cage' of ovulating females to experiment with."
Two years later, the first large-scale study of norethinodrel's contraceptive effect was conducted in Puerto Rico and Haiti. Investigators chose Puerto Rico not only because the island had no Comstock laws, but also because they wanted no interference from U.S. reporters -- a hype-control strategy still carried out in third-world countries. Additionally, Puerto Rico had a network of family planning clinics through the assistance of Sanger's Planned Parenthood affiliates. Following studies there, then in John Rock's fertility clinic, and finally at a Massachusetts hospital for psychiatric patients, the FDA, based on limited studies, and no long-term studies of its effects, approved "the pill" for birth control in 1960. This was the first product approved by the FDA that was designed not to treat an illness, but rather to modify a normal physiological process.
Today, "the pill" is made up of two different formulations. One is the progesterone-only pill (POP), containing either levonorgestrel or norethisterone. The other is the combined oral pill (COCP), which also contains estrogen. While both estrogen and progesterone are found normally in women, the hormones ingested with pills are "synthetic." All of these combinations of pills cause changes in the healthy tissues of the body and can have serious short-term and long-term side effects.
Scientists who worked on and promoted the pill knew of some of the deleterious effects of synthetic hormones, since as early as 1896 the connection between estrogens and cancer had been established. And by 1932 they knew that estrogens and progesterone could cause changes in the womb, breasts, ovaries, and pituitary glands of animals. Between 1940 and 1971, many women in the U.S. were prescribed diethylstilbestrol (DES), a synthetic form of estrogen, to prevent miscarriage, premature labor, and related complications of pregnancy.
According to the National Cancer Institute, "women who took DES during pregnancy have an increased risk of breast cancer. Increased risks of clear cell adenocarcinoma of the vagina and cervix and of breast cancer have been found for daughters of women who took DES during pregnancy; fertility problems are also more common among these daughters."
By 1967, British researchers conclusively linked the pill with thrombosis. Though rare, it can be fatal. In more recent years, the pill continues to be linked to thrombosis but also to breast cancer, cervical cancer, infertility, liver cancer, and stroke. The World Health Organization has classified hormonal contraceptives as a Group 1 carcinogen -- a substance that causes cancer. Lanfranchi, a breast surgical oncologist, has compared the pill to a molotov cocktail that you throw at a young girl's breast; she has wondered how often physicians prescribe a Group 1 carcinogen. These risks are increased if women have never been pregnant, are black Americans, and/or do not possess what are called "protective genes" -- known as BRCA2 or BRCA1.
The relationship between the pill and breast cancer is fairly simple to understand: both pregnancy and contraceptive hormones cause breast tissue cells to multiply, resulting in immature breast cells. While a completed pregnancy causes these cells to mature, contraceptive hormones with their added estrogen can directly damage breast tissue DNA. Breast tissue remains susceptible to cancer until it undergoes the stabilizing transformation in the childbearing process, which makes the pill particularly dangerous to women who have not yet had their first child -- perhaps the largest group of pill-users in the U.S. Studies have linked pill use to a 660-percent rise in non-invasive breast cancer since 1973. This also explains why women who have gone through childbearing are considered a lower risk for breast cancer.
The Mayo Clinic meta-analysis in 2006 concluded that breast cancer risk rises 50 percent for women taking oral contraceptives four or more years before a full-term pregnancy. "Oral contraceptive (OC) use early in life is associated with more aggressive [breast cancer] disease. OCs can be carcinogenic, especially when used before first full term pregnancy. The nulliparous breast is composed of undifferentiated structures, and it is only during a full-term pregnancy that the breast attains its maximum development." In 2009, the Fred Hutchinson Cancer Research Center found that women starting the pill before 18 nearly quadruple their risk of triple-negative breast cancer. Hakan Olsson, a Swedish oncologist, concluded that pill use before the age of 20 increases a young woman's breast cancer risk by more than 1,000 percent.
One of the greatest problems with "the pill" is lack of informed consent about risks and side effects. Barbara Seaman, a medical journalist during the 1960s, received a large number of inquiries from her readers about the new pill. As the pill's complications became more clear, she wrote the 1969 groundbreaking book The Doctor's Case Against the Pill to expose the information. (Drug industry pressure resulted in Seaman being fired.) As a result of her exposure, however, the Senate held hearings in 1970 to highlight a woman's right to informed consent about the pill's side effects. This led to the Food and Drug Administration's requirement that PPIs (patient package inserts) be included with the pill, establishing an historical precedent and, as DeMarco pointed out, altering the patient-physician relationship.
Though some feminists demand the right to free contraceptives as part of "reproductive justice," others refer to said "right" as "oppression by the pill." Some demand "reproductive freedom," but others refer to the pill as medical exploitation by the patriarchy.
Each year, more than 175,000 women in the U.S. develop breast cancer, and more than 43,000 die from it. In spite of these statistics, Health and Human Services secretary Kathleen Sebelius said in 2011 that it was urgent that college students have access to free contraception. One wonders if feminists are victims of their own ideology (and that of Big Pharma).
These statistics are not religious or political -- they are scientific. Clearly, breast cancer is a disease of women. So yes, this is in fact "about women's health."