Thursday, April 19, 2012

The Health Risks of Oral Contraceptives

I do not know if the non-medical advocates of hormonal contraceptives for birth control have their information wrong or they are just like those health professionals who are succumbing to pressures from health policy makers and government. I say this because it seems to me that there is a continuous refusal to see the facts that indeed there have been many documented adverse reactions resulting from contraceptive use, the latest of which is The Lancet study, that reported that there is a strong link between HIV transmission and the use of hormonal contraceptives, particularly injectable hormones such as Depo-Provera aka "the shot".

This is not the first time that evidence against use of oral contraceptives have been found.  In September 26, 2011, the US FDA has expressed "concern over the potential increased risk of blood clots” associated with the use of one of the most popular types of birth control pills. The pills in question contain the progestin drospirenone, and have in recent years been marketed to young women under such trade names as Yaz, Angeliq and Yasmin in the Philippines. There is also an increased incidence in breast cancer and increased risk of cervical cancer due to contraceptive use as reported by the National Cancer Institute of the National Institutes of Health.  Oral contraceptives are not to be used in women with a history of stroke, heart attacks, blood clots, liver disease, breast cancer or are over 35 years old and smoke. They do NOT provide any protection against any sexually transmitted diseases, including HIV.  This last information is very important in this day and age where many girls become sexually active at an early age and where oral contraceptives are easily made available to them. Studies show that hormonal methods of birth control, such as Depo-Provera (the shot), the patch, and oral contraceptives, can actually increase your chances of getting an STD from your partner if he is infected.  Depo-provera will suppress the immune system, and hormonal methods can make the reproductive tract more vulnerable to infections like HIV and chlamydia. There are also many other side effects that need further study like the disruption of the psychological and physiological health of women. Users of oral contraceptives have seen side effects like migraines, mood swings, altered memory, and vomiting; and young women seeking pregnancy-free sex might experience a decrease in libido from these pills, as well as fertility problems that may arise in the long-term especially for women who have never been pregnant before, which is an ironic consequence .

With all these information, why does our government push for hormonal contraceptives, intrauterine devices (IUD), injectables and other allied reproductive health products and supplies to be considered under the category of essential medicines and supplies? Is the purpose really to empower women by making oral contraceptives/ injectables/ IUD's, etc. available for free? Or is it because the WHO (and USAID, for that matter) says so? The World Health Organization's defines essential medicines as those medicines that satisfy the priority health care needs of the population. I cannot see the rational thought on how oral contraceptives can fall under "priority health needs". Just as I cannot understand how women of child-bearing age could be labeled as "high risk for pregnancy"...since when has becoming pregnant seen as a disease?  As if pregnancy is akin to an epidemic. Since our government seem to abide with the WHO's guidelines, then maybe we should also be informed that the WHO also lists "safe abortion" as part of their packages of interventions for ensuring quality reproductive health, maternal, neonatal and child health services. The target group to be given free access to hormonal contraceptives are women of reproductive age who cannot afford to buy them. Most of these women are also poorly educated and may not have the capacity to understand the information given to them. The process of informed consent is not a guarantee that they get the knowledge, understanding and give consent. Oftentimes the informed consent process is not even done well, if not done at all!  Why are we giving the poorer sector of our society something that the rich and educated will not want for themselves? 

There are many other family planning methods available, including natural family planning...oral/hormonal contraceptives is just one of them.  Personally, the only sure way I know to avoid pregnancy is abstinence.  Of course, this is something that requires superhuman effort for most people. As to safe sex?...there is no such thing.

Photo retrieved from http://www.davegranlund.com/cartoons/2008/05/22/abstinence-2/

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