Blogger’s Note: This article is part of the
online collection of articles on Artificial Contraceptives for author’s
personal readings and supplemental e-notes in Catholic Morality course.
More
Research on What Women Are Not Being Told
By
Arland K. Nichols
Approximately
100 million women worldwide use some version of "the Pill," or
combined oral contraceptives. In the developed world, the use of some form of
contraceptive is nearly universal, with surgical sterilization and oral
contraception the most popular methods.[1] As the United States and other
Western powers continue to spend billions of dollars on the "reproductive
health" of women in the developing world, the numbers of users continue to
rise.
In
spite of the Church's consistent teaching through the centuries, Catholic women
use contraception at the same rate as non-Catholics. The contraceptive
mentality, as Blessed John Paul II described it, has a dramatic impact on the
lives of Catholics everywhere and is a root cause of the culture of death. This
mentality was described by him in "Evangelium Vitae" No. 13 as
"a hedonistic mentality unwilling to accept responsibility in matters of
sexuality … a self-centered concept of freedom, which regards procreation as an
obstacle to personal fulfillment." It is characterized not only by
widespread promiscuity and diminishing respect for women, but by a view that
only life that is "wanted" or convenient is to be valued and
protected.
Considering
the growing body of evidence which calls into question the safety of the most
popular forms of oral contraceptives, we can see that the negative social and
moral effects so presciently identified by Pope Paul VI in "Humanae
Vitae," are now correlated with increased and serious risks to women's
health.
It is well established, if not well
known, that combined oral contraceptives bring a heightened risk for a number
of maladies -- breast, liver and cervical cancers, heart attack, stroke, and
blood clots, to note a few.[2] To exacerbate the problem, two recent studies
have shown that one of the newest and most popular types of oral contraceptives
brings an even greater risk of what one study describes as "the most
important safety issue for these products" -- venous thromboembolism, or
VTE.
VTE
refers to the formation of blood clots in large veins (deep vein thrombosis)
that can break loose, travel through the blood stream, and eventually block an
artery in the lungs (pulmonary embolism). VTE may be responsible for some
100,000 deaths each year in the United States alone. The surgeon general of the
United States considers VTE "a major public health problem, exacting a
significant human and economic toll."[3] Though the majority of VTE events
occur in older populations, combined oral contraceptives increase the risk of
blood clots for women during their childbearing years.
Normally,
after a given drug has been in circulation for some time, the medical community
arrives at a consensus concerning the risks posed by the drug. Such a consensus
has arisen with reference to the second and third generation of combined oral
contraceptives and the incidence of blood clots. The Physicians Desk Reference
states that "an increased risk … is well established" and the Federal
Drug Administration confirms that "[a]n increased risk of venous
thromboembolism (VTE) (deep venous thrombosis [DVT] and pulmonary embolism
[PE]) is well established and has been consistently reported."[4] Users of
second and third generations of oral contraceptives have a two to seven times
greater risk of VTE than non-users.
The
newest (fourth) generation of combined oral contraception contain both
synthetic estrogen and a progestin called "drospirenone." Marketed
under the trade names of Yaz, Beyaz, Yasmin, and Safryal, these contraceptives
have led to a financial windfall for Bayer Pharmaceuticals, earning over $780
million in the first nine months of 2011.[5] This financial success can be
attributed in part to the marketing campaign which, until recently, was
directed toward young women in their teens and early 20s. Television and online
advertisements showed spry, independent, and carefree young women who had been
set free from the "burden" of their fertility, monthly cycles,
Premenstrual Syndrome, and acne. The Yaz Web site featured an interactive,
colorful, and trendy city block in which young women could peruse the stores
and learn all about the positive benefits of Yaz.
This
light hearted sales approach has changed, however, as 10,400 lawsuits have been
served upon Bayer in response to side-effects from Yaz as of Oct. 8, 2011.[6]
Further, in early 2011 two studies were published by the British Medical
Journal indicating that women who use Yaz had a two to three times greater risk
of blood clots than women who use other combined oral contraceptives. In May,
the Federal Drug Administration (FDA) responded by launching a safety investigation,
and announced in September that "preliminary results of the FDA-funded
study suggest an approximately 1.5 fold increase in the risk of blood clots for
women who use drospirenone-containing birth control pills compared to users of
other hormonal contraceptives."[7]
In
late October, the FDA confirmed these findings. On the heels of this
confirmation came another extensive study of 329,995 women in Israel, which was
published in the Canadian Medical Association Journal (CMAJ) on Nov. 7.[8] This
study corroborated the FDA's investigation, showing an increased risk of 1.5
times that of other forms (second and third generation) of oral contraceptives.
The authors noted that "the risk of venous thrombotic events was
significantly greater among drospirenone users than among users of third
generation combined oral contraceptives." This study concluded that one
out of every 1,000 women who use drospirenone containing contraceptives will
experience a VTE during use.
This
was followed four days later by yet another study conducted in Denmark and
published in the British Medical Journal, which found that the risk for women
who use Drospirenone OCPs have "a sixfold to sevenfold increased
risk" of VTE compared to non-users.[9]
The
authors of the CMAJ study noted that they do not know the reason why the risk
is so much greater, but stressed that "it is important to raise awareness
of the increased, albeit small, risk of venous thromboembolism relative to
third-generation pills."
It
is laudable that the authors want to raise awareness of this risk to women's
health, and it is surely also a moral obligation. Before addressing this moral
obligation one rightly asks, is this risk really "small?" To consider
this question it might be helpful to crunch some raw numbers from the two
recent studies.
If
the 100 million women who use oral contraception today did not do so, we could
expect 30,000 women from this group to experience VTE. If we use the most
conservative numbers from the studies cited here and assume that half of the
women on oral contraceptives used second and third generation pills and half
used drospirenone containing oral contraceptives, we can expect some 80,000
women to face life-threatening blood clots.
This
means that 50,000 more women would suffer from life-threatening blood clots in
one year alone!
Now
consider the Guttmacher Institute's suggestion that women should be on
contraceptives for 30 years if they are to have the typically desired number of
children -- two.[10] To continue our projection, if 100 million women used the
pill every year over 30 years, some 2.4 million women will experience deep vein
thrombosis, 1.5 million of whom would face this life threatening event because
they used oral contraception.
Perhaps
we should not be surprised that such significant health risks would follow the
embrace of ideals that are also morally problematic. The Catholic Church has
consistently taught that married couples may not deliberately make the marital
act infertile. Regrettably, most couples ignore or are ignorant of this
teaching. Also, many women are prescribed oral contraceptives who are not
married, often to alleviate painful periods, irregular cycles, and other
reproductive health difficulties. Such use is not intrinsically immoral, though
it may be imprudent.
Regardless,
people of good will should agree that physicians have a moral obligation to
inform women of the potential negative side effects of any drug they prescribe,
including oral contraception. Yet, women regularly report that they are not
informed of the well-established risks. A nationwide survey conducted by HLI
America in November of 2010 found that only 40% of those who use oral
contraception report being warned by their physician that using the drug
increases the risk of blood clots. This is unsettling: Women have a right to
such information and physicians have a responsibility to provide it.
The
use of oral contraception today has become so routine and the contraceptive
mentality has become so pervasive that women do not know about the
well-established risks they face when they use combined oral contraceptives.
Women, not to mention marriage and society, would be better served if greater
knowledge of the well-established health risks encouraged a cultural shift away
from the de facto use of contraceptives and encouraged greater openness to the
gift of life.
Blessed
Pope John Paul II emphasized that the contraceptive mentality is at the root of
the culture of death. Scientific studies like those cited here only strengthen
the case that health and life are better served when we refuse to rely on
contraception and are open to new life.
__________________
[2]
Arland K. Nichols, Misleading Leadership: The Deliberate Deception of
Recommendation 5.5, The Linacre Quarterly, February 2012 V. 79 N1)
__________________
Arland
K. Nichols is the national director of HLI America, an educational initiative of Human
Life International. His writing can be found on HLI America's Truth and Charity Forum.
