I am concerned about the use of hormonal contraceptives in my clients.

With regards to hormonal contraceptives, conventional medicine considers these safe. However, with 4 out of 5 American women having taken these, it is very difficult to discern harm. Alternative health practitioners generally regard HCs as harmful, and synthesized hormones as toxins.

HCs lower the risk of some cancers, but raise the risk for deadlier cancers such as breast cancer.

Monthly menstrual bleeding functions to detoxify the body in my opinion, and it is commonly asserted that the lack of monthly periods puts men at risk of iron toxicity later in life and is the reason why men are hairier - to assist in extra detoxification. I don't agree entirely with the health professional who wrote the article below that "bleeds" on HCs do not have a health function.

Here is an article that generally lines up with my opinion. Please do not feel that you need to change your contraceptive to work with me, however!

Take care, Tracey

Article from www.sensible-alternative.com.au

The Problem with the Pill

(Lara's Problem with the Pill article was originally published in Nature and Health magazine).

Article Contents:

These drugs are not hormones

These bleeds are not periods

What is the evidence against the Pill?

PCOS epidemic

Alternative hormonal treatment

Alternative contraception

References

Have a consult at our natural hormone clinic

Imagine a substance has been proven to cause strokes, liver damage and many types of cancer. The world cancer authority lists it as a Class 1 carcinogen, but the substance is willingly consumed by more and more people. The authorities do nothing to warn the public, and instead, they actively promote its consumption.

Sound like tobacco? Sound like some worrying food additive? The substance is actually the Birth Control Pill.

The medical community is locked in a paradigm. Because the Birth Control Pill is backed by a very strong pharmaceutical lobby, it remains entrenched as standard care, with hardly a voice of dissent. Despite the evidence, our regulatory Health agencies are simply not able to admit the obvious thing: The Pill is bad for women's health. The Emperor has no clothes, but no one will speak it.

During my 10 years in practice in Women's health, I have been continually mystified as to why women take the Pill so willingly. One explanation is that the information that they obtain from their doctors is faulty. But there is something else beneath that: Both women and their doctors have a basic misunderstanding of what the Pill is.
These drugs are not hormones

Women and their doctors appear to believe that the oestrogen-type substances in the Pill are, in some fundamental way, the same as their own hormones. They assume that the chemicals in the tablet are no more than a simple replacement of what would normally be there anyway. In fact, nothing could be further from the truth.

The ingredients in the Pill are not at all the same as naturally occurring hormones. They are foreign, toxic steroid drugs, and, despite what your doctor tells you, they cannot be used to balance your hormones.

Pharmaceutical substances contained in the Pill are molecularly distinct from human hormones. Molecularly, the difference may be slight, but biologically, it is very significant. Hormone receptors are exquisitely sensitive. They respond differently to a differently shaped molecule. Some of the responses are vaguely similar, which is why the Pill can have some benefits, but some of the responses are very different, and many are downright sinister. For example, ethinylestradiol, a common ingredient in birth control pills, is 1000 times more potent in some tissue than its cousin human oestrogen (1). This is why ethynylestradiol increases the risk for breast cancer, and why it causes side effects such as bloating, fluid retention, and depression. Bear in mind that we do not understand all of the things that hormones do. The responses of hormone receptors are very complex. Only some of the undesirable effects of ethynylestradiol are known. How many more are unknown?

Progesterone-type drugs, called progestins, also produce undesirable effects. They distort and antagonise the effects of progesterone. Consider this: Human progesterone is naturally abundant during pregnancy, and natural progesterone cream can be used support pregnancy and to prevent miscarriage. Progestins, on the other hand, are a completely different story. They are not good for pregnancy. In fact, they cause abortion and birth defects. Up to 3% of women taking the Pill become pregnant and unknowingly continue to take the Pill. Research shows that this can cause foetal abnormalities, particularly to the reproductive organs. Reproductive abnormalities may not become apparent until the child is an adult and encounters difficulties with their own fertility.(2)
These bleeds are not periods

The other misunderstanding about the Pill is about the bleeds that occur. They are not periods. They are pharmaceutically induced bleeds, and they do not, in any sense, reflect the cycling of the body's own hormones. The fact that the bleed occurs 'monthly' is an arbitrary decision made by the designers of the Pill to reassure women that they still have 'periods'.

The continuous -dose Pill has recently been approved in the US, and will soon be available in Australia. These Pills are taken continuously with only 2-3 bleeds in a year. There has been some concern about the unnatural lack of periods. In my view, continuous dosing is no worse than a dosing that allows an arbitrary monthly bleed.

According to research by the pharmaceutical companies, the continuous-dose Pill has been demonstrated to be safe. In fact, if you look closely at the studies, these Pills are 'as safe as monthly oral contraceptives'. In other words, continuous dosing was compared to monthly dosing. For obvious reasons, the pharmaceutical companies did not feel the need to compare the continuous dose Pill to no Pill at all.
What is the evidence against the Pill?

The strongest case against the Pill is that its pseudo-hormones are listed as Class 1 Carcinogens. The listing was made in 2005 by the Agency for Research on Cancer (IARC), a division of the World Health Organization. (3)

This follows closely on the listing of HRT drugs under the same classification, which is logical, because the hormones in the Pill are very similar to the hormones in HRT. And consider this: When HRT use dropped by 68% between 2001 and 2003, breast cancer rates dropped by 11%, a decrease never before seen in breast cancer rates. According to the National Cancer Institute in the US, the drop in cancer rate can probably be attributed to the drop in HRT use. (4)

The IARC listing was made after a review of all studies available in 2005. Since then, the Mayo clinic has published another meta-analysis linking the Pill to cancer. The researchers looked at 39 studies published since 1980, and concluded that the pill increases the chance of breast cancer in young women by 150%. (5)

Breast cancer is not the only cancer risk. The Pill also increases the risk of liver and cervical cancer. Women are also more likely to have an abnormal PAP smear while taking the Pill.

If a cancer risk is not enough, there are other dangers to consider:

The Pill increases the risk for life-threatening blood clots, particularly deep vein thrombosis (DVT), but also for heart attack and stroke. A landmark meta-analysis in 2005 documented that women taking the low-dose Pill have double the risk of heart attack, stroke and DVT (6). What is remarkable about this meta-analysis is not just that the risk was found to be 'highly significant', but that this is the first time that such a study was made. In other words, the drug has been used for four decades, and this is the first meta-analysis to ask whether there is a cardiovascular risk. Another finding is that the risk for DVT is actually higher for the new generation of Pills than for the older versions. The increased risk is attributed to the use of a different progestin. The progestin had been changed in an attempt to avoid progestin side-effects such as abnormal blood cholesterol, weight gain and acne.

The Pill causes insulin resistance. This contributes to the cardiovascular risk, but it also increases the risk for diabetes and Polycystic Ovarian Syndrome (PCOS). (Perversely, the Pill is used as treatment for PCOS - see below.) (7) Insulin resistance also leads to weight gain. All Pills, even the so-called mini-Pill (8), have been shown to cause weight gain. The Pill does this in many ways. It suppresses thyroid function; it increases deposition of cellulite; and it induces testosterone deficiency. Women might want to remember that oestrogen-type drugs are fed to beef cattle to make them gain weight.

The Pill increases the likelihood of depression. A new study has found that women taking the Pill are almost twice as likely to suffer from depression. (9) It is the progestins that do it. They cause depression because they cause a serotonin deficiency in the brain. They also interfere with testosterone and progesterone, which are important hormones for mood. Once again, the thing to note about this study is that it is the first of its kind to look at the problem. For over four decades, women have been complaining that the Pill makes them depressed, but they have never been taken seriously by their doctors.

Certain types of Pill cause bone loss. In 2004, the US Food and Drug administration placed a 'black-box' warning on its injectable progestin contraceptive (brand name Depo-Provera). (A 'black box' warning is a warning used for serious adverse effects. It must be labelled with a black outline on the packaging.) The warning stated that the drug may cause significant, possibly irreversible, bone loss.(10) The minipill and the implant (brand name Implanon) contain the same progestin drug as the injectable.

The Pill lowers libido, which is a tragic side effect when the Pill is taken for sole purpose of being able to enjoy sex. Research shows that the effect on libido may be a long-term effect, even once the Pill is discontinued. This occurs because the Pill upgrades the production of a particular protein called sex hormone binding globulin (SHBG). SHBG stores testosterone, and when the liver makes too much SHBG, the result is that testosterone becomes unavailable, and sex drive drops off. The Pill has another detrimental effect on libido. It appears to disrupt pheromone communication between sexual partners. More specifically, it prevents a woman from producing copulin, which is a female pheromone that induces sexual interest in the male partner. (11,12)

If these serious adverse effects are not enough, there are other minor inconveniences. The Pill causes migraines, thrush, nutrient deficiencies, hair loss, and gallstones.

According to the official prescribing information for oral contraceptives, the Pill should not be prescribed if the patient has any of the following conditions: migraines, depression, endometriosis, obesity, diabetes, inflammatory conditions like Crohn's disease, herpes, epilepsy, elevated cholesterol, and many others. GPs routinely ignore these warnings, and do not advise their patients of the risks.
PCOS epidemic

Polycystic ovarian syndrome (PCOS) is a common hormonal problem. It affects one in ten women, and the percentage may be even higher among young women. Its principle feature is a lack of regular ovulation. It causes facial hair and infertility. The incidence of PCOS is on the increase and this trend to an epidemic has not yet been explained.

There is good evidence that many cases of PCOS are caused, in part, by insulin resistance, a metabolic problem that also causes weight gain and diabetes. This is bad news for Pill users because as discussed above, the Pill actually worsens insulin resistance. In 2003, the Journal of Clinical Endocrinology & Metabolism published an article called 'A Modern Medical Quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills'. (13) The Pill has been standard treatment for PCOS, and yet, perversely, it appears to worsen the metabolic problem that is at the root of the condition. The authors say: ...what has been lacking is a critical examination of whether oral contraceptives might...exert adverse metabolic effects with long-term consequences...

I propose that the Pill may have made additional contributions to the epidemic of PCOS. Many young women have taken the Pill since they were in their early teens. This was done, and yet studies have shown that the Pill causes permanent hormone changes, even once it is stopped. (14) Most doctors agree that it can take 1 to 2 years for normal menstrual cycles to resume after stopping the pill (15,16,17). Why should we not consider a history of Pill use when it comes to PCOS? Strangely, this question has not been asked in the medical literature.

What is even more worrying is that the hormonal damage from the Pill may not be limited to one generation. A new understanding of genetics has shown that the lifestyle of our parents and our grandparents can affect our health in this generation. In particular, the effects of hormone disrupting chemicals such as pesticides have been shown to cross generations. (18) The Pill definitely qualifies as a hormone disrupting chemical. Young women today have inherited their genes from a mother and grandmother who used the Pill. Has there been a cross-generational effect? No studies have been done to answer this question.

For alternative treatment for PCOS, see PCOS article.
Alternative hormonal treatment

In the sphere of conventional medical, the Pill is used a panacea for any hormonal problem that should arise. As we have seen, this approach is deeply flawed. The Pill creates the very hormonal imbalance that it is supposed to be treating. Fortunately, there are many other effective options for treatment of hormonal symptoms.

Take acne as an example. Acne is usually the result of food sensitivities to sugar, dairy or flour. Stress hormones also play a role. Admittedly, the oestrogen-type drugs in the Pill can override the problem by thickening the skin and by decreasing sebum production. The resulting clearer skin does not mean that the powerful steroid drugs have done anything to address the underlying cause, or to balance hormones. The acne will reappear with a vengeance when the Pill is stopped. An alternative, but equally effective approach, is to improve the diet and to supplement skin-friendly nutrients such as B-vitamins and zinc. Such an approach will provide a more long-lasting benefit, without the cancer risk!

For other alternative treatments, see PCOS and Endometriosis articles.

There are literally hundreds of natural treatments that are effective for symptoms of hormonal imbalance. Consult Sensible-Alternative Clinic (details below) for advice.
Alternative contraception

The Best method for contraception: Symptom-thermal method:

The symptom-thermal method is a completely drug-free method of timing sex according to a woman's non-fertile time. A 2007 study has found it to be as effective as the Pill.

In a study of 900 women over 10 years, German researchers found that the sympto-thermal method of contraception was as effective as the Pill in preventing pregnancy (19). The study is about to be published in the medical journal Human Reproduction.

The symptom-thermal method uses calendar, mucus, and oral temperature to identify a woman's fertile time. A woman's body temperature rises by 0.3C with progesterone secretion following ovulation, and it stays elevated until the period arrives. The fertile time occurs just before this temperature rise, and is 5-6 days for most women. A change in cervical mucus is observed at that time. During the 5-6 days of fertility, it is necessary to abstain or use barrier methods, such as condoms.

When used properly, the method produced unintended pregnancy rates at the low rate of 0.4% per year, which is actually lower than the Pill's rate of 1% per year. (To be rated as highly effective, a contraceptive method must have a failure rate of 1% or less per year.)

Even when not used properly, the unintended pregnancy rate was only 1.6% per cycle (compared to 25% per cycle with no contraception). This low pregnancy rate is attributed to the fact that couples had sex on the edges of their fertile period, and were still able to avoid the most fertile day.

Researchers concluded that the method is easy to learn, and easy to stick with. 70% of the couples in the study stayed with the method for at least 1 year. This compliance rate is as high as any contraceptive method studied.

New computer fertility monitors will make this method of birth control even easier to use. Fertility monitors test hormone levels of urine sticks for 10 days per month. The monitor can then give the green light for unprotected sex during a non-fertile time. When used alone, the fertility monitors claim a success rate of 94%. If combined with the temperature method discussed above, that rate would be even higher.

The symptom-thermal method and/or the fertility monitor are best suited for women who have regular cycles. They should not be relied on during the first 2-3 months coming off the Pill when the periods are irregular. Proper instruction in the symptom-thermal method is recommended.

Diaphragms and condoms:

Diaphragms and condoms are barrier methods. When used correctly, the diaphragm is 96% effective and condoms are 98% effective. Care should be taken the condoms do not contain spermicide. Spermicide is toxic to the hormonal system.

Intra-uterine device (IUD)

The intra-uterine device (IUD) is another drug free method. It is a device placed in the uterus to prevent implantation of the embryo. Historically, IUDs had a bad reputation for causing pelvic inflammatory disease (infection), but the new designs have a significantly lower risk for this complication.

"Modern IUDs are safe, effective, and reversible, but only about 2 percent of U.S. women use them," said Nancy L. Stanwood, M.D., M.P.H., assistant professor of Obstetrics and Gynecology at the University of Rochester Medical Center (20). Australian statistics are similar, and, in fact, many young women have never even heard of IUD's, and have been told that the Pill is their only option

IUD's are 99.9% effective at preventing pregnancy,a nd can be inserted in the doctor's office. Short-term side effects include a possible increase in period pain and flow.

Non-hormonal IUDs are a viable alternative. Talk to your GP.

Hormonal IUD

I used to recommend a progestin-secreting IUD (Brand name Mirena in Australia), but many patients have reported side effects from it. Progestin is an artificial progesterone, and some progestin products like the arm implants (brand name Implanon) have been shown to cause serious side effects like irreversible bone loss.

It is best to avoid any contraceptive hormones, however the delivery system.

Is surgical sterilisation a good option?

Sterilisation for women is tubal ligation. In this procedure, women must undergo laparoscopic surgery, with a general anaesthetic. The surgeon clips the fallopian tubes. Tubal ligation has no immediate detrimental effects, but over the subsequent years, it may decrease the production of progesterone. Progesterone deficiency causes hormonal symptoms such as PMT and fibroids. Fortunately, should it arise, progesterone deficiency can be managed with treatments such as natural progesterone cream. Conclusion: All things considered, tubal ligation is not ideal, but it is definitely a better option than the Pill.

Sterilisation for men is vasectomy. A minor surgical procedure is used to clip the tubes that carry sperm. Sounds easy, but a worrying concern has emerged. There is evidence that vasectomy may increase the risk for a form of dementia called primary progressive aphasia (PPA). This condition occurs in men and women and is sometimes mistaken for Alzheimer's disease. Researchers from the University of Illinois looked at 114 men (47 with PPA, 57 without). They found that of the men with PPA, 40% had undergone a vasectomy (compared to only 16% of men without PPA). Also, the men who had had a vasectomy developed PPA earlier than PPA victims who had not had a vasectomy. Damage to the brain may be the result of antibodies that are formed when sperm leak into the blood stream. (21) Conclusion: Vasectomy is not recommended.

References

* 1.Wright, VJ & J. Morgenthaler. Natural Hormone Replacement. 1997. Smart Publications. Petaluma, CA.
* 2.Oral contraception linked to prostate deformities. NewScientist. 3 May 2005
* 3. International Agency for Research on Cancer. PRESS RELEASE N� 167
* 4.29th Annual SABC: Abstract 5. Presented December 14, 2006
* 5.Barclay, L et al. Oral Contraceptive Use Increases Risk for Premenopausal Breast Cancer. Mayo Clinic Proc. 2006;81:1287, 1290-1302
* 6.Baillargeon, JP et al. Association between the Current Use of Low-Dose Oral Contraceptives and Cardiovascular Arterial Disease: A Meta-Analysis. J Clin End Met 200590(7): 3863-3870
* 7.Nader, S et al. The effect of desogestrel-containing oral contraceptives on the glucose tolerance and leptin concentration in hyperandrogenic women' J Clin Endocrinol Metab 1997 82: 3074-7
* 8.Depot medroxyprogesterone acetate for contraception causes weight and fat gain in women. Nature Clinical Practice Endocrinology & Metabolism 2005 1(69)
* 9.Kulkarni J et al. Depression associated with combined oral contraceptives--a pilot study. Aust Fam Physician 2005:34 (11): 990.
* 10.Pfizer. Letter to healthcare professionals. Available at: http://www.pfizer.com/are/news_releases/2004pr/mn_2004_1118_letter.pdf
* 11. Caruso, S et al. A prospective study evidencing rhinomanometric and olfactometric outcomes in women taking oral contraceptives. Human Reproduction 16(11): 2288-2294
* 12.Michael, Richard P. et al. Volatile Fatty Acids, 'Copulins', in Human Vaginal Secretions. Psychoneuroendocrinology, 1: 153-163
* 13. Diamanti-Kandarakis, E et al. A modern medical quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills. J Clin End Met 2003.88(5): 1927-1932
* 14. Panzer et al. Impact of Oral Contraceptives on Sex Hormone-Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction. The Journal of Sexual Medicine. 2006. 3:p.104-113
* 15.Farrow, A et al. Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception. Hum Reprod. 2002. 17(10): 2754-61
* 16. Gnoth, C et al. Cycle characteristics after discontinuation of oral contraceptives. Gynecol Endocrinol 2002:16(4): 307-17.
* 17. Vessey, M et al. Return of Fertility after discontinuation of oral contraceptives: influence of age and parity. The British Journal of Family Planning. 1986: 11: 120-124.)
* 18. Anway et al. Epigenetic Transgenerational Actions of Endocrine Disruptors and Male Fertily. Endocrinology 2006.147(6): 43-49
* 19. Frank-Herrmann P, et al. The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple's sexual behaviour during the fertile time: a prospective longitudinal study. Hum Reprod 2007
* 20.�Young Women Unfamiliar With Safety, Effectiveness Of IUD� . ScienceDaily (Dec. 16, 2006)
* 21. Weintraub, S et al. Vasectomy in Men With Primary Progressive Aphasia. Cognitive & Behavioral Neurology. 2006: 19(4):190-193.

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