Brigitte Lynne Noel: Here are my questions – just want to preface this with information I obtained from another interview yesterday… It would seem that despite the various definitions that specify Centchroman is NOT a hormonal drug, its behaviour as a "selective estrogen receptor modulator" does in fact make it a hormonal option.

Tracey TieF: My thoughts precisely! It is possible that the drug is less harmful than synthetic hormones, which are Class 3 carcinogens according to the World Health Organization, but it is possible that interfering with oestrogen reception has other harmful consequences.

BLN: I know you've told me you don't know much about this drug, but what are your thoughts on Centchroman?

Tracey TieF: As a natural health practitioner and health service consumer, I do not trust drug companies to conduct long-term, thorough safety testing on the drugs they develop and market. It is not in their interests to do so. Pharmaceudical companies interests are to get a drug out as soon as possible and to earn as much money as possible on the drug before its exclusive patent runs out.

BLN: Women are talking about this drug on forums and giving each other advice on how to purchase it online from India. What do you make of this?

Tracey TieF: When a person takes a medication that is not approved in Canada, it's likely that her medical practitioners are unaware of the drug's side effects, and possibly that the patient is taking the drug. She cannot get proper medical advice. She may not report side effects that may be dangerous, such as cardiovascular symptoms. She may be prescribed medication that interacts adversely either because the prescribing practitioner did not know she was on the drug, or does not know enough about the drug. It's a dangerous set up, and it shows how desperate women in Canada are to find alternatives to conventional hormonal contraception.

BLN: What do you think this says about our healthcare system, if anything?

Tracey TieF: Although I am a natural health practitioner, I confess that I don't understand well how our drug approvals work here in Canada. I suspect that when drugs are unavailable, it's because Big Pharma has not wanted to invest the time and money required in order to get approval to sell in our relatively small marketplace. If Health Canada itself conducted safety testing - if our society wanted to take back control of the pharmaceutical industry and invest real money into research - Canadians could prioritize life saving and big impact drugs such as contraceptives. Big Pharma prioritizes drug testing and marketing based on money alone - what returns can be had. Women and children's well being should not be at the mercy of big drug companies' agendas.

BLN: What should women keep in mind when seeking different options of birth control?

Tracey TieF: Ideally, women can have a fully informed conversation with their doctor or naturopath. But today, doctors and even women's sexual health counsellors don't know about, or have access to, the range of options. This makes a helpful consultation impossible!

Healthy contraception and STI prevention should be a part of every Woman's Sexual Health Plan (annual exam, PAP tests, contraception, back up contraception, communication skills). When a woman can consider her full range of options, from condoms, through diaphragms, cervical caps, contraceptive gels, IUDs, hormonal contraceptives and surgical interventions (vasectomy, tubal ligation), she can ask herself:

How will I avoid Sexually Transmissible Infections?

How will this method fit with my habits and lifestyle? Taking a pill every day is easy for some, difficult for others. Inserting a diaphragm or Fem Cap before intercourse suits many women, but not all.

How might this method affect my fertility? My health in 5 years? My health in 10 years?

What are the consequences of an unplanned pregnancy? What are my options in that case (contraceptive morning-after pill, abortion, adoption, having a bonus baby!)

How reliable have I been with my previous methods? Barrier methods have higher failure rates largely because the method is not used some of the time, while perfect use rates are comparable to hormonal contraceptives. For instance, the Fem Cap with contraceptive gel could be 98% effective, but in trials, the actual rate is close to 79% because of incorrect or non-use.

How will my partner(s) participate in this method?

Is the prescribing health practitioner aware of risks and side effects and do I trust them enough to report difficulties and seek help?

What will this method cost (one-time cost? monthly? annually?) and who will pay (self, insurance, partner(s)).

I am an advocate of fertility awareness and barrier contraception. Barrier methods are simple, accessible, low cost, easy to learn, easy to use, and generally free of harmful side effects. Barrier methods are 100% reversible and do not affect fertility. Women who have taken hormonal contraception wonder if they've been damaged when they experience problems conceiving.

Unfortunately, women can't rely on conventional medical practitioners, or even women's sexual health clinics, for complete information on contraceptive options. Women, especially young women, are most often told that the only option is condoms and "The Pill". Even when there are serious side effects, such as heavy prolonged bleeding leading to "anaemia", more hormonal contraception - usually heavier dose pills - is given as the answer.

My clients tell me over and over again that their doctors and sexual health clinics did not know about the Fem Cap (cervical cap) or Contragel Green (contraceptive barrier without nonoxyl-9), or did not know where to get it. Women are doing their own research, their own presecribing, their own sourcing. When it comes to drugs, going behind your doctors back does not sound like a good idea. But when it comes to barrier contraception, I hope women take control, talk to each other, share experiences and bring what they've learned back to the doctor's office. "Here's a Fem Cap, here's Contragel, here's my experience, here's where women can buy it."

If you have more questions, please ask!

Best, Tracey
Tracey TieF
Certified Natural Health Practitioner