A short essay about the history of birth control.

October 31st, 2016 was when the Australian Broadcasting Corporation (ABC) posted an article titled:

‘It’s 2016. Why don’t we have a male contraceptive pill?’

In this article, author Ange McCormack discussed a recent trial for a potentially new form of contraception for men. I know, exciting right! This could be a HUGE step towards gender equality. Men finally taking responsibility for their sperm and not expecting us women to deal with all of the consequences!

Co-created by endocrinologist Professor Robert McLachlan, the contraception, in the form of an injection, suppresses the pituitary gland, reducing the sperm count to near zero and therefore preventing pregnancy. The global trial was conducted in 2011 and involved a total 320 men. The end results were positive for the future of the contraception, with 3 in 4 participants happy to continue using the contraceptive (news.com.au, 2016).

How amazing would it be to finally get a break and share the burden with our male counterparts! Alas, don’t get your hopes up, ladies.

Unfortunately, the trial was cancelled early (thanks, World Health Organisation), due to some (presumably the remaining quarter of participants) complaining of various side effects; ranging from pain surrounding the injection site, an increased sex drive, acne issues, mood swings and allegedly, depression. And yes, allegedly, because as Professor McCormack told the ABC,

‘The trouble is, if you take a few hundred patients and follow them for a couple of years, how many do you think will naturally run into depression? Of course, some of them will.’

In fact, current statistics state that 1 in 8 men will experience depression (beyond blue, 2016). Therefore approximately 40 of the 320 patients could have suffered from depression then, anyway. The WHO’s decision to terminate the project seems to be a gross overreaction. And yes, they have terminated it, not put it on hold for further development to be released later, but chucked it all out the window, for it to be blown away by the wind and never seen again.

(tumbleweed gif retrieved from giphy.com)

Now, if we time travelled to Peurto Rico in 1956, we would stumble across another life changing trial – the first oral contraceptive pill for women. Of course, trial regulations were very different then to what they are now, but (and I think you’ll agree with me here), the side effects from this trial greatly exceed the ‘concerns’ from our modern day contraception counterpart. So don’t worry guys! Keep reading and you’ll see what happened a mere 60 years ago.

The first brand of the pill (known as Enovid), had a whopping 10,000 micrograms of progestin and 150 micrograms of estrogen. For those of you who are like me and don’t really know what that means, I’ll repeat the comparison that the Planned Parenthood Federation of America (2013) document provides. The current contraceptive pill includes 50-150 micrograms of progestin and 20-50 micrograms of estrogen (Knowles & Ringel, 1998; Tone, 2001). That means 1 pill from 1956 contains roughly a weeks’ worth of the hormones in our current pill.

The current pill already wreaks havoc with our bodies. I struggle to imagine what the additional micrograms would do to me! So I did some reading and collated all of the more severe* mentioned side effects of the original pill, and there they are:

  • Damage to the liver,
  • Damage to the cervix,
  • Damage to the liver,
  • Damage to the ovaries,
  • Vomiting,
  • Blood clots,
  • Breast tenderness,
  • Weight gain,
  • Heart attacks,

and

  • Strokes.

Before we go any further it is exceptionally important to note that this trial was conducted in Puerto Rico. While there were some trails conducted in American cities, such as Boston, they were eventually cancelled due to the intolerable side effects experienced by the participants. Unlike the American trials, the trial in Puerto Rico lasted for years, where the women weren’t even informed that they were taking an experimental drug! Once these women were on the pill, they weren’t given the option to dispose of the drugs when they experienced its many consequences. Many Puerto Rican women (and one American woman) died during this time. Congestive heart failure, pulmonary tuberculosis, strokes and heart attacks were the main causes of discomfort and deaths experienced by many who took this medication (Quintanilla. R, 2004, Chicago Tribune).

I cannot comprehend why they continued the trial when it was clear there were a number of negative side effects! I am forever grateful for the sacrifice these women made to improve our quality of life today. Without it, women’s rights would have been pushed back another 60 years.

Image result for the invention of the contraceptive pillSourced from the Australian Broadcasting Corporation

1961 was the year Australian women finally got the pill. Whoops, sorry, married women got access. Yep, only married women (Robinson. D, 2010) and even if you were married, you had to convince your reluctant (religious) doctors to prescribe it to you.  Over in America, the FDA were presented with a report of the drug’s effectiveness. Despite all of the evidence that said they pill was not ready for public consumption, they declared that a death rate of 1.3 of 10,000 female users was a much more bearable statistic than the 36.9 of 10,000 women who die from pregnancy complications (many of which were presumably due to unsafe abortions (ABC, 1997)). It took scientists over 10 years to realise that create a more effective pill with fewer hormones, bringing the death rate closer to 0 in 10,000.

“In the era before the arrival of the Pill, unsafe abortions were the single greatest cause of maternal death.”
ABC 1997, Time Frame – Full Circle

Why the delay?

Now I know times have changed since the 1950s, and I’d like to believe that if this trial was to happen in 2017, more funding would be awarded to get that death rate to zero before the product was put on shelves. But why were so many women’s lives disregarded in the process of testing? And then, even more, when it was made available? Some countries did choose to make it unavailable, deeming the risks too great, such as Norway and the Soviet Union, who made the sale of the pill illegal in 1962 (Asbell, 1995).

In 1969 a book was published by Barbara Seaman titled The Doctor’s Case Against the Pill. This book carried a lot of weight in the fight against the pill and drew the attention of Senator Gaylord Nelson. While some of the accusations in Seaman’s book were true, many were not. It did not cause cancer, nor did it cause sterility. In 1970 Senator Nelson held hearings to determine the effects of the pill, wishing to judge how informed its users were and the safety of this medication. During these hearings feminists were known to be protesting the use of the pill, stating that they were never consulted upon taking the pill themselves or asked what they thought about it.

Hugh Davis, who had financial stakes in IUD’s, took a stance alongside the book’s claims, promoting IUD’s in substitution of the new contraceptive pill. (This later turned into a disaster for women’s health and bankrupted the IUD’s then manufacturer.) After a few months of hearings, they concluded that the FDA would agree to incorporate an information insert to inform users of the risks (Planned Parenthood, 2013). Yup, that’s right. The users who were prescribed the pill didn’t even know the risks until 1970, 9 YEARS after it was released to married women.

Even in 2017, the pill still isn’t perfect. In 2010 there were 1,100 lawsuits against the Bayer Healthcare Corporation as 3 types contraceptive pills were the cause of blood clots, heart attacks and strokes (Nikolchev. A, 2010). I know many women who can’t use (and sacrifice a lot when they do) the modern day pill, or its counterparts, without having debilitating reactions. Constant bleeding, never-ending menstrual cramps, headaches, nausea, significant weight gain and a significant decrease in sex drive are among some of the things I have discussed with my girlfriends. The impact this injection could have had on those people’s lives would have been phenomenal! Being able to share the responsibility with their partner and have some relief would be of huge help to the women who can’t use modern contraception. For a developed society like ours to totally disregard a very positive drug trial is a huge shame.

WHO and pharmaceutical companies have really underestimated the need for the male contraception injection. When aligning the two trials side by side, it seems to me that there is a much higher regard for men’s health than women’s and clearly a higher regard for people of Anglo-Saxon origin compared to the people of Puerto Rico. For this modern-day trial to be terminated without any prospect of being revisited soon because white men experienced some minor discomfort is ridiculous. It is one of the ultimate examples of gender and race inequality, and the ultimate example of hypocrisy to claim that Anglo-Saxon men cannot deal with such side effects, but all women must.

 

 

*The list of side effects to the pill that I have compiled is nowhere near comprehensive. I have only listed the most life-threatening and life-altering consequences of the Enovid drug. Weight gain, breast tenderness, headaches, and nausea are just a few more of the other side effects. Many of these are still an issue with the current pill and its many variations today. All side effects listed are compiled from the below articles and documents.

 

** If you want to learn more about the pill and the sacrifices made by its participants, my citations are below. I encourage to you educate yourself and learn where our privilege has come from and who sacrificed their well-being for our privilege.

 

http://articles.chicagotribune.com/2004-04-11/news/0404110509_1_gritty-village-pill-humacao

http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/

http://www.fpa.org.uk/sites/default/files/contraception-past-present-and-future-factsheet-november-2010.pdf

https://www.plannedparenthood.org/files/1213/9611/6329/pillhistory.pdf

http://www.abc.net.au/triplej/programs/hack/male-contraceptive/7981328

http://www.news.com.au/lifestyle/health/why-big-pharma-wont-develop-the-male-contraceptive-that-works/news-story/1ddd8544131c05898c3e8c895086f7a2

http://www.abc.net.au/archives/80days/stories/2012/01/19/3411425.htm

http://www.abc.net.au/science/kelvin/files/s17.htm

Title image sourced from Wikimedia: https://commons.wikimedia.org/wiki/File:Opened_Oral_Birth_Control.jpg

Tumbleweed image sourced from http://giphy.com/gifs/bare-barren-Az1CJ2MEjmsp2

For further reading:

http://www.sbs.com.au/topics/life/health/article/2016/10/31/extremely-effective-male-contraceptive-injection-trial-ditched

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