On The Pill
AKIE BERMISS: As a male, my interaction with “the pill” (in its various forms) is always at least one-degree removed. Much though I may be invested in someone I’m with and whether or not they are “on the pill”, I can’t personally take a birth control pill. Well, I suppose I could, but it wouldn’t do much for me in the way of contraception. And so, to a certain extent, there is a pervasive feeling of helpless dependency where birth control is concerned. One has to depend on the pill for that 99 percent assurance that no child will be conceived during intercourse and, if one is male, one has to depend on their partner to take the pill in order to get assurance of that assurance.
You would think, for most men, that this would be a humbling and humiliating experience. That the thought of being powerless with one’s own future would make a person feeling bitter, upset, and betrayed. And yet so many of us go through life blithely thinking nothing of it. “Oh, she’s on the pill? Great!” But still we’re remove from it. We never have to take it. We just watch the woman take it — and cheer her on, I guess.
It may’ve been foolish to accept so readily the gift of impermanent sterility. And, looking back, I think any pill that can make nature do back-flips is probably something a young person should be very wary of. Then again, young people don’t make wise decisions. If there’s one thing you can usually depend on, its young people making bad decisions, actually. When you’re drinking and smoking and staying up all night, your main concerns are not how healthy your lifestyle is. But, rather, how awesome. And so it behooves us, as adults, to be mindful of how we teach/force our children to be responsible. As doctors, nurses, advisors, parents, mentors and so on — we should be mindful of what we tell children. Too often we’re just trying to prevent the worst from happening. DON’T GET PREGNANT. So we tell them: get on birth-control. And think we’ve dodged the bullet. All too often this is the tack taken with young adults. Just prevent the worst from happening and let the rest sort it out. But if you don’t dialogue with a teenager (or even someone in the early 20s) about sex, and contraception and the risks and rewards, its just as half-assed as when they give heroine addicts methadone and expect that to make everything better.
Well since my great epiphany during college, I’ve been very concerned about birth control drugs and the human body and what it does to women long-term. And why there are no available male birth-control drugs. And how to get through to young people about the risks involved. But I still remain a perfect outsider when it comes down to the nitty-gritty. On the one hand, I am concerned. On the other hand, I’m always at least one degree removed from the actual contraception. So what weight do my words carry anyway?
There is one answer, though, that might give relevance to all this wool-gathering and this is: if we could get men involved in this decision a little more actively and a little sooner, that might help to open things up a bit. One should strive to know what one’s partner is going through. Even if one can’t ever truly empathize with them, its important that there is an attempt to consider the plight of the other. That maybe instead of just cheering women on, we also ask the question of what this could mean for women in the long run.
Or otherwise wallow in that helpless dependency. Assuming ignorance is bliss and that this is woman-talk.
EMILY SAIDEL: Birth control should be regarded as any other healthcare issue that involves coordination and consultation between healthcare professionals and patients. The choices to be made about delivery system (pill, patch, implant, shot, ring, etc), hormones (estrogen, progestin, desogestrel, ethinyl estradiol, etc), and dosage are the key positives of this form of contraception, because the variety allows a woman to find the product that suits both her life style and her chemical responses. As Planned Parenthood puts it, “Birth control methods are not one-size-fits-all.” Additionally hormonal use is not limited by a motivation to prevent pregnancy.For women seeking to treat symptoms associated with heavy or irregular menstration, hormone based contraception often offers a solution.
Taking advantage of this variety also requires responsibility on both sides of the healthcare equation. Prescribers need to be both aware of and effectively communicate the possible side effects of each method, and patients need to be attentive to their bodies’ reactions and willing to return to the professional to say ‘This isn’t working.”
According to the National Cancer Institute, studies on long term oral contraceptive use and increased cancer risks have trended toward no increased risk in breast cancer following long term usage and a reduction in the risk of ovarian and endometrial cancer as results of birth control usage. Nor has long term use been associated to increased infertility following that usage. As can be seen by ongoing lawsuits involving Yaz, Yasmin, and Ocella, the potential risks continue to be monitored, particularly as new methods and formulas are developed. However, monitoring risks is not the same as blanket fear or condemnation of hormone use.
The ability to control the menstral cycle and fertility has been lauded for offering women a way to control conception and has been denounced for the same. But the decision to partake in any of these methods is as medical as it is moral, and thus necessarily requires the communication between patient and doctor that any medical issue demands.
MOLLY SCHOEMANN: I definitely agree with Emily that doctors should be consulted before any kind of prescription birth control is chosen, and I also agree with Akie that we also need to delve a little more closely into exactly what our prescriptions are meant to do.
I, merrily, did neither of those things when I first went on the Pill in college. I barely thought twice about it, to be honest, and the doctor who prescribed it didn’t bat an eyelash as she wrote me out a prescription. Why would either of us hesitate? My little sister and some of her friends were already on the Pill to help control their cramps and clear their skin up, and most of my female friends who were sexually active were on the Pill for pregnancy prevention. It seemed like the thing you did once you reached a certain age. After all, why risk the chance of becoming pregnant, when all you had to do was take a tiny little pill at the same time every day?
I went off and on the Pill in several different forms and strengths over the next several years, as various relationships waxed and waned. I can’t recall a single discussion I ever had with a doctor who prescribed it about the fact that by ingesting a steady stream of hormones for three weeks out of every month, I was preventing pregnancy because I was fooling my body into thinking it was already pregnant.
When I finally learned this, and really absorbed the ramifications, I was a little taken aback. It seemed like a bad idea. Was this really what millions of American women were doing in order to prevent pregnancy? Was this really the best method modern science had come up with? I was frustrated with myself that I had not been more educated about this method of birth control before using it for several years, but the truth is, it had seemed like a no-brainer. The ubiquity of hormonal birth control in the United States is troubling to me for many reasons, not the least of which is because it has fostered a culture in which otherwise curious, intelligent young women turn to it without question. It is only in the United States that use of the Pill is omnipresent; in the rest of the world, the IUD is the most popular reversible birth control method.
As more and more methods of administering hormones have come about—namely the patch and the ring, it has led me to further question the safety and reliability of these newer methods. They seem gimmicky and poorly thought out—created to be marketed as the next big break in birth control—when they’re really just the same old hormones, repackaged and rushed onto the shelves. The idea that you can trust an inanimate patch or a plastic ring to regulate the way hormones are absorbed into your bloodstream seems laughable. There are already dozens of lawsuits against the makers of the NuvaRing and the Ortho Evra Patch for serious side effects such as blood clots.
If nothing else, my experiences with hormonal birth control have taught me that it is important to educate myself so that I can make informed choices about my health, particularly when it comes to extremely popular and widespread options. If I don’t question them, no one else will do it for me.