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June 4, 2009

The Pill Kills Women?

The American Life League's newest anti-contraception campaign is called The Pill Kills Women. On Saturday, June 6, anti-choicers across the country will be protesting outside doctor's offices, pharmacies, Planned Parenthood clinics and other family planning facilities in order to "educate" American women about how the birth control pill is GOING TO KILL THEM! OMG! Yeah, whatever. (Last year's theme was The Pill Kills Babies, which was also bullshit propaganda, obviously).

Now, we're definitely not saying that hormonal birth control is totally safe for everyone or completely free from side effects or risks. According to the American College of Obstetricians and Gynecologists, birth control pills are not recommended for women who smoke, are over 35, or are obese. Women with high blood pressure, high cholesterol, or diabetes also need to be monitored if taking oral contraceptives.

But to jump to the extreme that "the pill kills women!" is a scare tactic designed not to protect women but to control what women do with their own bodies. For most women, especially young women, experts say the benefits of birth control pills far outweigh the risk. A large percentage of the resources cited by this campaign have a strong anti-choice/anti-contraception bias, such as LifeSiteNews and many of the studies that come from reputable sources have been misinterpreted or misrepresented. I don't for one second believe that the American Life League is concerned with women's health. The Pill Kills Women campaign is offensive not just because it's full of misinformation, but also because they are trying to use us to make their political statement and support the anti-choice agenda.

There's just too much wrong with this campaign to cover in a single blog entry, so consider this part one. Let's look at how the pill allegedly kills women...
Increased risk of heart disease
The Department of Biomedical Sciences and Technologies at the University of Udine, in Italy, conducted a study in 2008 that showed the pill increases the risk of heart disease. Women on the pill were over four times more likely to have high levels of CRP (C-reactive protein) and 3.9 times more likely to have levels of CRP high enough to cause an "intermediate risk" for heart disease. [Life Site News]

It's true that older versions of hormonal contraception did increase the risk of heart disease somewhat, but newer formulations of birth control pills that contain less estrogen are considered safe. There are studies that have suggested that there may be a link between the pill and heart disease, but there are also studies that suggest that such a link does not exist. These contradictory findings have yet to result in a conclusive connection. The best preventative measure at this point is to limit other heart disease risk factors, like smoking.

Also, you have to put it all into perspective. Women of child-bearing age have a low risk for serious heart disease (the risk for death from heart disease is about 0.002 percent per year for women under 35). So even if birth control pills do increase those odds, the odds are still really really low.

Increased risk of breast cancer
In her talk on "A New Beginning" at the 2006 Humanae Vitae Conference, endocrinologist Dr. Maria Kraw discussed the pill’s serious side effects. "Looking at 54 studies of the pill, she observed that researchers found that it caused a 24% increased risk of breast cancer." [Life Site News]

Some studies have shown a slight and temporary increased risk of breast cancer in women taking oral contraceptives, , but other studies have shown no change in risk. It's also worth mentioning again that the level of hormones in birth control pills has changed since they were first studied. Many of today's low-dose pills contain less estrogen and progestin than older versions. The level of natural hormones in a woman's body also affects her risk of developing breast cancer. Not having children or having a first child after the age of 30 can also increase the risk. Since birth control prevents pregnancy it might somewhat help explain an apparent relationship between contraception and breast cancer without proving a causal relationship.

Interestingly enough, oral contraceptive have been shown in multiple studies to decrease the risk of ovarian, endometrial, and colorectal cancers.
Increased risk of cerbrovascular disease and cervical cancer A woman taking the pill is 1.9 times more likely to die from cerebrovascular disease and 2.5 times more likely to die from cervical cancer. This came from a study that was published in 1999 in a British medical journal. "The 25 year follow-up study with 46,000 British women also notes that the enhanced risk of death lasts for 10 years after women have stopped taking the pill." [Life Site News]
There is evidence that taking oral contraceptives for a long time temporarily increases the risk of cervical cancer. But women who have had multiple pregnancies also have an increased risk of developing cervical cancer. And of course, it's important to remember that birth control pills only protect against pregnancy and not STDs... not using a condom also increases the risk of cervical cancer by increasing the risk of HPV transmission.

As for this "cerbrovascular disease"... I assume they mean cerebrovascular disease or stroke. Now it goes without saying that birth control pills already have warnings against use if you have a history of or risk factors of stroke. There is an increase in stroke risk when using birth control pills, but in healthy young women who do not smoke, do not have persistent high blood pressure, and do not have migraines with neurological symptoms... the risk is low. New versions of the pill, which contain lower doses of estrogen, are associated with a lower risk of stroke than older versions. Women also have an increased risk of stroke during pregnancy and the weeks immediately following pregnancy.
Increased risk of plaque buildup in arteries
A study on 1,300 women aged 35 to 55 found that the women who take oral contraceptives may have more plaque buildup in their arteries. The study was done in Belgium by researchers at the University of Ghent. It was discovered that every 10 years of oral contraceptive use was connected with a 20–30 percent increase in plaque buildup. [Life Site News]
This one is just a repetition of earlier side effects, rephrased to look like something more. One of the main reasons for the suggested increase in risk of heart disease is because of an apparent increase of plaque buildup in the arteries. (As we already mentioned, the findings on the heart disease link are not yet conclusive and were minimal at best). It's misleading to portray this as another way that the pill "kills" women, when really plaque build up in the arteries is for the most part a cause of two already mentioned risks - heart attack and stroke. These are not necessarily additional dangers.

Also, while it's true that any increase in plaque buildup is thought to place a person at risk, researchers believe that the plaque buildup observed in these studies is too small to lead to an increase in heart disease risk in otherwise healthy people. (Again, all the more reason not to smoke if you take the pill). And as previously mentioned, many of the women in these studies had taken earlier versions of birth control pills that contained much higher estrogen levels.
Increased risk of raising your blood pressure
Studies done on 60,000 women, 35,000 of whom were taking birth control pills, showed that “a rise in blood pressure occurs in virtually all women who use OCs [oral contraceptives] for [six] months or longer.” The studies also showed an increase in heart attacks and strokes. [NCBI]
And again, it's heart attacks and strokes. How many different ways are they going to spin that one? Okay first of all, the article cited is from 1982, so the research must be from even earlier and therefore likely applies to earlier generations of birth control pills that are not as safe as today's versions. Secondly, while the studies did show a rise in blood pressure, it's important to note that the increase was considered "generally mild". Extreme caution is advised in prescribing oral contraception for "susceptible persons" (i.e., people with known risk characteristics such as diabetes, cigarette smoking, hyperlipidemia, etc.) but in the absence of these additional factors the risk is quite low.
Increased risk of liver problems
Several cases of liver tumors were found in young women who had been taking oral contraceptives. These case studies took place in the U.S., Great Britain, Italy, South Africa and several developing countries, and they show a connection between tumors of the liver and the use of oral contraceptives. [NCBI]
The article cited (published way back in 1991) references two main groups of studies. Basically, the gist is that oral contraceptives were found to increase the risk of liver cancers in populations usually considered low risk, but not increase the risk of liver cancers in populations usually considered high risk. So what does it mean? The data isn't conclusive enough to make any real determinations, but while there is a chance that birth control pills will increase your risk of liver cancer... if your risk is already low, the increased risk will still relatively low, especially in cases of short term use. There was evidence that the risk of benign liver tumors increased with oral contraceptive use, but the increase is considered by most experts to be very small and also only after longer durations of use (4-8 years+).

So while we'd be lying if we said "taking birth control pills is the healthiest thing you can do!" I think it's pretty clear that a lot of these terrible dangers are really negligible risks at best. (Also, FYI: progestin-only pills have a lower risk of side effects than combination pills). Obviously the birth control pill is not right for every woman, but for many people the benefits far outweigh the risks. Especially when you consider that pregnancy also increases a woman's health risks:
Studies show pregnancy is linked to a two- to three-fold increase in the odds of heart attack, an eight-fold increase in the odds of stroke, and as high as a 50-fold increase in the odds of blood clots. Hormonal birth control pills look quite safe by comparison. [ABC News]
And let's not forget that the pill has other other health benefits (in addition to pregnancy prevention):
  • decreases menstrual blood loss
  • decreases pain and cramps
  • decreases PMS symptoms
  • decreases PMDD symptoms
  • regulates menstrual cycle
  • improves acne
  • improves hirsutism
  • improves endometriosis
  • improves symptoms of rheumatoid arthritis
  • prevents bone loss
  • reduces risk of ovarian cysts
  • reduces risk of ovarian cancer
  • reduces risk of endometrial cancer
  • has a beneficial effect on cholesterol
Overall, the majority of heart attacks and strokes attributed to hormonal contraception use occur in women who smoke. Considering the many many risks associated with smoking - whether you use birth control or not - and the fact that cigarettes have no health benefits, one really has to wonder why the ALL hasn't started a "Cigarettes Kill Women" campaign.

You know, if they really cared so much about saving women's lives...


ceirdwenfc said...

>one really has to wonder why the ALL hasn't start a "Cigarettes Kill Women" campaign.

Or McDonald's (or any other fast food chain) since as far as I can tell, except for breast cancer, they contribute to all the other factors that you mention.

I don't understand these people - especially this week.

Not that it's anyone's business, but I've never had an abortion, but I have used Planned Parenthood. They were there for me when I had no health insurance and needed a gyn exam or was I supposed to wait three years until I got the insurance?

These people are nutters.

Allison said...

Their energies might be better spent pushing vasectomies (quick in-office) over tubal ligation (major surgery).

To be fair, though, the birth control pill-death connection is a lot stronger than the tenuous abortion-breast cancer link that was pushed big-time a few years ago.


We've actually addressed the myth of the ABC link in the past.

Anonymous said...

You know what else kills women/girls? Abusive fathers, husbands and boyfriends. Who beat their wives/girlfriends/daughters to death.

Childbirth kills women too. So does aspirin, cars, and and weight-loss surgery. I don't see any protests about those.

tehfanglyfish said...

Ultimately, nature kills women. No matter how much you eat right , exercise, take your vitamins (only now they say not to, or at least some of them do), get regular screenings for various diseases, pray to whatever deity you might hold dear, the fact of the matter is, you're going to die. Nature's a bitch like that. I say we protest nature!!!