Prescription Not Necessary
The American College of Obstetricians and Gynecologists (ACOG) and scientists at a non-profit research group recommend that drug regulators make birth control pills available over-the-counter (OTC) to increase women’s access and prevent unplanned pregnancies. Researchers say it is justified because 50 percent of pregnancies are unintended and cost taxpayers 11 billion dollars a year. It is been established as a very effective contraceptive and previous research has shown that the women are more likely to use it when it is OTC and that they make good decisions when weighing the small risk of side effects. One major concern is that if it is OTC, it may be expensive and likely be ineligible for 100 percent coverage under the Affordable Care Act.
Estrogen Supports Bad Bacteria
A new study in the New England Journal of Medicine has shown that endogenous estrogen supports the existence of a “mucoid” form of Pseudomonas aeruginosa, a bacteria that forms a layer of slime on the lungs of cystic fibrosis (CF) patients and explains why women with it do worse than their male counterparts. People with CF have dysfunctional chloride channels which target the lungs and the gut, resulting in a chronic buildup of mucus that creates an environment for bacteria to grow and leads to infections and inflammation which ultimately damages the lungs. Women on the pill had lower amounts of these bacteria which was likely due to have lower natural estrogen levels. These results may have implications in understanding how sex hormones affect other respiratory diseases.
Cost May Be Biggest Obstacle
A study involving more than 7,500 women enrolled in the Contraceptive CHOICE project found that hormonal implants placed subcutaneously in the upper arm and intrauterine devices (IUDs) were more effective than the pill and the vaginal ring. Of the 334 pregnancies during the study, almost half related to birth control failure, only 21 were women using IUDs or implants. Women under 21 had twice the risk of an unplanned pregnancy if they were on the pill or using the ring. Researchers speculate that forgetting to take a pill every day and the difficulties in getting a refill add to these numbers. Unfortunately, the initial costs of IUD and implants are expensive which prevent many women from using them and are only used by 5.5 percent of American women who use birth control.
Hormones Hell on the Gut
Results from two studies found that younger women on the pill tripled their risk of Crohn’s disease and post-menopausal women taking hormone replacement therapy were 1.7 times more likely to develop ulcerative colitis. Crohn’s disease results when the lining of the small and/or large intestines becomes inflamed to the point of bleeding. Ulcerative colitis is inflammation of the colon or rectum can lead to diarrhea, abdominal cramps and bleeding of the rectum. Researchers stressed that these studies did not show a cause-and-effect relationship, but the strong association of Crohn’s and the pill do concern them, especially in young women with a family history of the disease. Previous animal studies have demonstrated that estrogen makes the colon more susceptible to inflammation.
Babies Later, Bonuses Now
Even as various state legislatures debate the issue of subsidized contraceptives, a study by economists at the University of Michigan and University of Virginia has found that approximately two-thirds of American women's wage gains from the 1960s to the 1990s was due to the ready availability of birth control pills, and that just having access to contraceptives at age 18 increased a woman's later earnings by 8 percent over women denied access until age 21. According to lead economist Martha Bailey, given "the expectation of greater control over childbearing, women invested more in their human capital and careers." The study, published online this week by the National Bureau of Economic Research, analyzed the careers of some 4,300 women born from 1943 to 1954.
The Pill That Pays for Itself
At a juncture when publicly funded contraception for women has become a political issue, a timely new report from the Brookings Institution asserts that family planning support programs save taxpayers from 2 to 6 dollars in government expenses for each dollar invested. The report notes that nearly one-half of all pregnancies in the U.S. are now unintended, and that children born into these circumstances are more likely to experience poverty, fail academically, engage in criminal activity or have physical or mental health problems, all of which run up public health, safety and welfare costs. According to the report, one specific proposal, an expansion of access to Medicaid family planning programs at a cost of $235 million, would save an estimated $1.32 billion.
The Pill As Pollution
A new study has directly linked the number of women on the oral contraceptive known as "the pill" with death rates due to prostate cancer and researchers believe that the estrogen which is excreted through urine ends up accumulating in the drinking water. Animals and plants that consume the water also take up this estrogen called ethinyloestradiol which humans end up ingesting. Previous research has linked estrogen and compounds such as BPA that mimic the hormone to prostate cancer because of how they act on cells even though many of the studies that examined blood hormone levels have yielded mixed results. One explanation is that the estrogen acts in the tissues so a correlation based on blood levels cannot be made. No other contraceptives were linked to prostate cancer.
New Methods Not Better or Safer
A six year study has shown that Yaz, a newer birth control pill manufactured by Bayer, increases the risk of blood clots by 75 percent compared to other forms of birth control in a cohort of over 800,000 American women. Yaz contains the hormone drospirenone which is made in the lab. The Ortho Evra patch and Nuvaring, which use estrogen and two other hormones, also increase the likelihood of problems. Some health officials are questioning why new drugs that are no better than the older ones and carry a higher risk are being put on the market. A previous study involving over 1,000,000 women from Denmark found that using Yaz doubles the blood clot risk compared to levonorgestrel, an older hormonal birth control pill which is contrary to earlier research showing there was no increased risk.
Infection, Transmission Doubled
A new study from the University of Washington suggests that hormonal contraceptive use in African women increases the risk of HIV infection and transmission. Researchers looked at 3,790 heterosexual couples in which one was HIV positive and found that uninfected women using hormonal contraception, including the pill and Depo-Provera, were two times more likely to become infected with HIV. For women who were HIV-positive and on birth control, the risk of transmitting HIV to their male partner was twice that of infected women not using birth control. Over 140 million women around the world use hormonal contraceptives such as the birth control pill which is taken orally and Depo-Provera which is administered by injection to prevent pregnancy.
Affects Left Brain Memory
Results of a new study from the University of California Irvine has shown that the pill reduces a woman’s ability to remember details, providing insight into how men and women remember things and process stress differently. Two groups of women, some on the pill and some not, were shown pictures and told about a car accident involving a mother and her son. Within each group, women were told varying details of the story and took a pop quiz one week later in which they had to recall it. Women on the pill remembered the main points but could not remember details such as objects around the accident scene. Researchers are not surprised since the pill lowers estrogen and progesterone which strengthen “left brain” memory. It is not viewed as a deficit, but as an alteration of the brain.
One Protein, Two Diseases
A protein initially discovered in bone is also present in breast cells and appears to be related to both osteoporosis and breast cancer. Previous research has shown that RANKL turns on the cells that break down bone when it needs to be replaced, but if too much is expressed and the bone cannot be replaced, osteoporosis results. A recent study found that HRT and the pill trigger RANKL in breast cancer by preventing mammary cells from dying when they should, and allowing stem cells to renew themselves. When the protein was inhibited in mice they developed fewer tumors. A monoclonal antibody, denosumab, was just approved in the U.S. and Europe for osteoporosis works by inhibiting RANKL and is being looked at as a possible treatment for women whose breast cancer has metastasized to bone.
Yaz Plus Folate
A new birth control pill that prevents parenthood may also reduce the incidence of certain birth defects. A new birth control pill approved by the U.S. Food and Drug Administration, called Beyaz, contains not only estrogen and progestin but a folate, levome folate calcium, a B-vitamin recommended for women of childbearing age. The hope is that women who stop the pill when they want to conceive will decrease the odds of neural tube birth defects linked to a deficiency in folate. The most common side effects were uterine bleeding, nausea, breast tenderness and headache. Blood clots and liver disease were two of the serious side effects. Beyaz is contradicted in women 35 years old and older. It includes the same amount of estrogen and progestin as the birth control pill Yaz.
1 in 5 at Risk on the Pill
Birth control pills are contraindicated in women with congenital heart defects, but 1 in 5 are on it because they were not educated on the risks. A study in Germany of 536 women with heart defects found that 48 percent were not told about the risks of blood clots and hypertension associated with pills containing estrogen and progesterone. Many had “absolute” contraindications such as severe heart failure, defects that impair the circulation of oxygen throughout the body, a history of blood clots and pulmonary hypertension. Managing adults with congenital heart disease is very new and gynecologists may not be aware of the issues that arise in these cases. Other forms of birth control such as condoms and diaphragms eliminate these risks but have higher failure rates.