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Contraception - Medical Effects

1.  What are the side effects of contraceptives?

 

 

FACT: Hormones have a profound and powerful effect on the body and undesirable side effects can be many, varied and far-reaching, from physical to emotional to psycho-social.

 

 

Abstinence during the fertile time should be considered as a better option than contraceptives in any form as there are no side effects.

Common physical side effects of contraceptives include:
  • Loss of libido
  • Depression and/or mood swings
  • Breast tenderness, nausea, weight gain and acne
More serious physical side effects of contraceptives:
  • Deep vein thrombosis resulting in stroke, a blood clot in the lung or death
  • High blood pressure
Planned Parenthood’s very own Guttmacher Institute,  found that over 50% of women who spoke to their doctor because of pill-related side effects complained about breast tenderness, nausea, weight gain and mood swings.[1] With so many unacceptable side effects, there has been a need to produce a second, third and now a fourth generation of oral contraceptives in an effort to minimise or eradicate adverse effects yet currently available oral contraceptives increase the risk of venous thrombosis up to 7-fold. Oral contraceptives still have a major impact on thrombosis occurrence and many women do not use the safest brands with regard to risk of venous thrombosis.” [2]Bayer AG paid $1.6 billion to settle claims by 6,800 women seriously injured by Yaz, including more than 100 deaths. Merck & Co. paid $100 million to settle claims by 3,800 women seriously injured by the NuvaRing including 83 deaths. [3]
 

2.  Does contraception just prevent fertilisation? How do contraceptives work?

 

 

FACT:  In order to prevent pregnancy, birth control pills employ several mechanisms.

 

 

1) they prevent ovulation.
2) cause a woman’s body to produce cervical mucus which is hostile to sperm and
3) cause thinning of the uterine lining.

The synthetic hormones may convince a woman’s body that she is pregnant. This can stop the ovaries from releasing an egg. Secondly, the Pill also makes it difficult for the sperm to reach the egg, because the hormones thicken the cervical mucus. Normally, on the days of each month when a woman is fertile, her cervical mucus has microscopic channels in it that make it easier for the sperm to travel to the egg. The mucus also nourishes the sperm, allowing them to live longer. However, when a woman is infertile (which is true for the greater part of each month) her cervical mucus changes. It looks more like a mesh or net at the microscopic level. The Pill causes the woman’s body to produce this type of cervical mucus on a continual basis, thus making it difficult for the sperm to live and move. The Pill also creates changes in the uterus and fallopian tubes that can interfere with the transport of sperm.[4] Despite the hormones’ ability to prevent the release of eggs, sometimes a “breakthrough ovulation” takes place. How often this happens depends upon several factors, such as which kind of pill the woman is taking, how consistently she takes her pills, and even how much she weighs. Even with correct and consistent use of the Pill, some formulas allow ovulation in less than 2 percent of cycles, while others allow a woman to ovulate during 65 percent of her cycles.[5]

When a woman ovulates, she can become pregnant. However, the Pill has several mechanisms that can cause an abortion before a woman knows that she has conceived. If a sperm does fertilize the egg, the newly conceived baby (zygote) may be transported more slowly through the fallopian tubes because of how they have been altered by the Pill. Thus, the child may not reach the uterus, where he or she needs to implant and receive nourishment for the next nine months. Because the fallopian tubes are changed, the baby may accidentally implant there, causing an ectopic or “tubal” pregnancy, which is fatal to the baby, and can also be life-threatening for the mother.

If the baby is able to travel safely to the uterus, he or she may not be well received. One reason for this is that the chemicals in the Pill thin out the lining of the woman’s uterus (the endometrium).[6] As a result, the baby may not be able to implant or may implant but not survive for long. The Pill also affects progesterone levels causing the lining of the uterus to break down and eventually shed as it would in a menstrual cycle, further denying the baby’s attempt to implant.

 Most common contraceptives are abortifacients. The birth control pill, the Morning-After Pill, the Patch, the intrauterine device (IUD), Implanon (implant)and Depo-Provera (injection) sometimes work by preventing a newly fertilised egg from attaching to the uterus. This causes a first trimester abortion to occur of which the mother is not even aware.

Since 1995, the pharmaceutical companies have been trying to use less oestrogen in their preparatiions and that means being less dependant on suppressing ovulation and more dependant on the other effects: altering the cervical mucus and the endometrium.  If anything, the contraceptives being used are likely to be more dependant on abortifacience.  To some extent all contraceptives are dependant on the abortifacient effect, it is a question of how much dependant and whether it is morally significant.  Contraceptives all have a failure rate which means that all three factors are involved in the success rate that they have.  No contraceptive completely prevents fertilization.
 

3.  What do groups like the World Health Organisation have to say about the link between hormonal contraception and cancer?

 

 

FACT: The World Health Organization, (WHO), classifies combined oral contraceptives (COC’s) as Group 1 carcinogens [7]- in the same group as asbestos, tobacco and arsenic.[8]+ [9]

It also states that the increased risk of cervical, liver and breast cancer is balanced by a decreased risk in the incidence of uterine and ovarian cancers and so “…the health benefits clearly exceed the health risk.”[10] In Australia however, the incidence of breast cancer is approximately 4 times greater than the incidence of ovarian or uterine cancer.[11] That is 1 in 9 women will develop breast cancer before the age of 85. In the WHO conclusion, it is hard to understand how a significant risk of breast cancer is outweighed by any perceived good derived from oral contraceptives.

Do contraceptives provide a health benefit as their marketing suggests? Certainly, they are a physiologically competent means of avoiding pregnancy. However, in order to continue their promotion, the pharmaceutical industry, along with many physicians who work with them, market them built upon these suggested benefits.”[12]

For example, it has been documented that the incidence of ovarian and endometrial cancer are decreased with the use of some oral contraceptives.   This is often referred to as a “health benefit”.[13]  “However, the increased risk of breast cancer in women younger than 45 years of age, invasive cervical cancer in women under the age of 60, and liver cancer in women who have used oral contraceptives is usually ignored.  Furthermore, the increased risk of breast cancer has also been associated with the use of Depo-Provera.”[14]

Dr. Chris Kahlenborn et al, concluded after rigorous and extensive research of 21 out of 23 studies that there is a significantly increased risk of 44%  of developing breast cancer in women who take oral contraceptives prior to their first full term pregnancy[15] -which is when many women take them.

His research should be particularly noted as it was not funded by the drug companies as is common but by a government grant and was published in a peer-reviewed journal whereas counter findings are often funded by vested-interest groups.

 

4. Is  Hormonal Menopausal Therapy safe?

 

 

 

 

FACT: In 2006, despite conflicting study results, the World Health Organization upgraded its 1999 classification for combined hormonal menopausal therapy from a group 2B (possibly carcinogenic to humans) carcinogen to a Group 1 carcinogen (carcinogenic to humans)

 

 

The International Agency for Research on Cancer “…highlighted the decrease in breast cancer incidence after the widespread reduction in the use of combined oestrogen-progestogen menopausal therapy since 2003.” [16]

According to the results of the Women’s Health Initiative (WHI) study, hormone replacement therapy side effects caused by its prolonged use include pulmonary embolism, increased blood pressure and cardiovascular disease. A combination of oral estrogen and progestin on a daily basis for a prolonged time increases the risk of heart attack or stroke. Nausea, headache, cramped or bloated stomach, anxiety, acne breakouts and swelling of hands and feet due to fluid retention, mood swings, irregularities in the menstrual cycle, diarrhoea, breast tenderness, patchy skin discoloration, irritated eyes, altered sex life and yo-yoing weight are some other common hormone replacement therapy side effects. A small percentage of women who were being examined as a part of the Women’s Health Initiative (WHI) study also complained about severe pain in the abdomen, double vision, depression, lack of appetite, unexplained vaginal bleeding and extreme fatigue. These along with jaundice and fever are some uncommon hormone replacement therapy side effects that are as equally severe as the more common ones.[17]

 



[1] http://sparky.guttmacher.org/pubs/journals/3008998.html
[2] British Medical Journal, May 2009. The Venous Thrombotic Risk of Oral Contraceptives etc. A. Van Hylckama Vlieg
[3] https://www.youtube.com/watch?v=cyHyR0x2dyo
[4]Walter L. Larimore and Joseph B. Stanford, “Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent,” Archives of Family Medicine 9 (February 2000), 127.
[5] Ibid.
[6] Physicians’ Desk Reference (Montvale, N.J.: Thomson, 2006), 2414.
[7] World Health Organization Statement  Sept. 2005
[8] https://papersowl.com/discover/known-and-probable-human-carcinogens                             
[9] http://monographs.iarc.fr/ 
[10] World Health Organization Statement  Sept. 2005
[11] www.nbocc.org.au
[12] Dr. Thomas W. Hilgers, Reproductive Anatomy & Physiology;  A Primer for Fertility Care Professionals.  Pope Paul VI Institute Press:  Omaha, NE. 2002. p. 103
[13] IBID. p. 104
[14] IBID. p. 104
[15] Mayo Clinic Proceedings October 2006
[16] The Lancet Oncology Vol. 10 January 2009
[17] http://hormonereplacementtherapysideeffects.org/

 

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