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Thinking Critically About the Pill

This interview with Laura Eldridge over at Bitch is worth a read. Eldridge is a feminist writer, and has been an outspoken opponent of hormonal birth control. There’s a lot she says that I disagree with, but I think this point is well taken:

It’s hard for anyone to be critical of the Pill, even if you’ve been studying this drug for years. Even now I feel I need to be cautious. I always want to be respectful of women’s choices, even when they are different from mine. I want to say from the beginning that the Pill works really well for many many women. If a friend of mine is doing well on it, I would never tell her get off.

Many women, though, are living with a very problematic method of contraception that they don’t like, even though there are other options out there. This has to do with their relationships with their doctors, their partners and how they see themselves fitting in to society in general. Analysis of women and the Pill can show both how far we have come and how far we still have to go.

While hormonal birth control is a great thing, it also is far from ideal for a lot of women (myself included). But if you don’t want to use a hormonal method and also don’t want to rely 100% on condoms, your options are pretty limited — most doctors won’t insert an IUD in a 20-something woman without kids, and diaphragms aren’t particularly convenient. And birth control is still the woman’s responsibility.

She also makes some good points about the Pill and other contraceptive methods being highly profitable for pharmaceutical companies, and those companies sometimes sometimes covering up or downplaying negative side effects. But that said? A lot of women love the Pill. For a lot of women, it’s enabled us to live our lives more fully; it’s meant that we can have some basic control over when we get pregnant, so that we can have fulfilling sexual lives while also pursuing our other goals. It’s hardly been a capitalist conspiracy; women have had to work damn hard to gain access to birth control on their own terms.

I’m also more than a little skeptical about her expertise when she claims that emergency contraception is non-hormonal and somehow different from the birth control pill. She also pushes fertility awareness at the end, which surely works for some women but is not nearly as effective as most other birth control methods, and just doesn’t work for a lot of us. And she doesn’t seem to put her commentary at all in context — being critical of the Pill and the pharmaceutical system is great, but that criticism is happening in a country where conservatives are trying to limit access to birth control (and, if they had their way, probably outlaw it). To leave that out of the conversation strikes me as a little irresponsible, or just clueless.

I’m glad to see feminists having critical discussions about the Pill, especially when they center on the many negative experiences that women have had with hormonal birth control. Too often the feminist line on birth control is “it’s great!” and that’s that. But there’s a reason feminists toe that line so strongly — it’s because of ongoing encroachments onto reproductive freedom, including birth control. To leave that out of the picture, and to pepper your interview with misinformation, makes the conversation less helpful and less productive than it could be.

UPDATE: Amanda has two posts on this topic that are worth a read, pointing out that a lot of the anti-Pill arguments are anti-science dressed up as “just asking questions”: One and two.


90 thoughts on Thinking Critically About the Pill

  1. Emergency contraception is a hormonal method, but because it’s taken only when you need it, it doesn’t carry the same risks of long-term exposure to hormones. Maybe that’s what she means?

  2. I’m a single 20-something without kids who just got an IUD. My doctor is the one who recommended it. It’s just been approved for women who haven’t given birth yet. It’s worth checking with your doctor because a lot of the studies are probably before the FDA approval (which was just a few years ago). It hurts like hell, but since I can’t take the pill for medical reasons, the doctor was actually pushing for me to get it.

  3. To be more specific, studies that show that doctors won’t give women without kids an IUD are probably outdated.

  4. When I got on HBC, my doctor offered the pill, Nuva Ring, depo provera, or Mirena. She let me make the choice as to which would work best for me. (I was 21 at the time.)

    After being on childfree forums, though, I know being offered an IUD without children is rare. I’m going to miss my doctor when I move for graduate school next fall.

  5. One problem is that some doctors jump up to a higher dose name brand instead of trying patients, especially those who are new to using birth control, with lower doses that usually have less side effects. I have a hormonal disorder, and a high dose, estrogen containing pill greatly helps my functioning, but my sixteen year old cousin was put on the same pill and her doctor did not listen to her complaints about symptoms. Luckily, she switched doctors and the new one gave her a lower dose that worked much better for her. Birth control pills, like any other medicines, aren’t one size fits all.

  6. I don’t hear feminists saying that the pill is great for everyone. I hear feminists pushing back against pseudoscience and scare tactics promulgated by the anti-choice crowd.

    1. I don’t hear feminists saying that the pill is great for everyone. I hear feminists pushing back against pseudoscience and scare tactics promulgated by the anti-choice crowd.

      Definitely. I didn’t mean that feminists say the pill is right for 100% of people. I just meant that — and I do this too — the discussion seems to be Feminists For The Pill and Anti-Choicers Against It. And it’s nice to see feminist discussions that are critical of how birth control isn’t always great for women, and it would be nice if we could have those discussions more often without pseudo-science and anti-choice agendas.

  7. I’m glad to see this conversation. I tried the pill but it turns out it’s not right for me at all & it exacerbated or possibly created some problems. I’m stuck with condoms for now, which aren’t problem-free either, not only because their success rate isn’t as high as the pill, but because I’m very picky about what kind of condoms I use.

    But at the same time I never, ever want to make it harder for anybody else to get the kind of birth control they want. And the pill, some women use it for reasons other than preventing contraception.

    And like looking back I remember thinking to myself that the pill was probably the right option for me at the time when I requested it from my doctor. I’d done some reading about it and nothing I read told me I might run into the problems that I ran into. But I’m a little upset that my gyno pushed *one* brand of HBC (It was the newest brand at the time) onto me instead of having a conversation like, “Okay, you want HBC. Here are several brands available and differences between them.”
    (I don’t know if I would have been any better off on one of the other brands.)

    I was very surprised to see, in a feminist book about sex & medicine I’m reading, criticism of other medical interventions in people’s sex lives (in particular ED drugs, and especially when sex drugs are marketed to women,) but absolutely no critical analysis of HBC in the same chapter! What gives? The book went into great detail criticism the pharmaceutical industry, but only as it related to trying to create libido drugs for women. I thought that leaving out a discussion of prescription contraception was a major, deliberate oversight.

  8. I also found the documentary about the Pill that came out several years ago to be very illuminating. It wasn’t so long ago that women had no choice when it came to birth control. To hear older women talking about what it was like to be free from the fear of having another child and truly enjoy their sexual relationships with their husbands? I would never underestimate that freedom, particularly given the current movement to restrict access to birth control.

  9. Seconding Flowers. The standard of care is no longer to refuse women without children getting IUDs because the new generation of IUDs is so safe. The advent of the Mirena IUD in particular makes IUDs an excellent form of contraception that’s statistically more reliable than the Pill (even if the Pill is taken correctly, but it is immeasurably more reliable when the common misuse of the pill is taken into account). The Mirena uses a tiny amount of hormone to discourage contraception–about equivalent to one day’s Pill–as opposed to copper wire, which all other IUDs use. That means that, as opposed to copper wire IUDs, which can increase cramping and blood flow during menstruation, it actually reduces menstrual symptoms (20% of women stop visibly menstruating altogether, a wonderful little side effect without having to use continuous-use BC). No, the hormone in an IUD doesn’t do crazy things to you like the Pill does because there’s so little of it.

    Mine hurt like hell when I got it put in, and for a few weeks after I’d occasionally be taken over by cramping attacks as it settled in. I bled/spotted for about 6 weeks solid. I even wanted to take it out at times. So yeah, it’s incredibly obnoxious, and is probably only for women who know they’re not going to want to have kids for several years (you have it taken out, and have to after it wears out in 5 years for Mirena, 10 for copper), especially given the investment in an OB-GYN visit and insertion, pain, and blood. But it’s unnoticeable now, works for 5 years, and is 98-99% effective. I think the feminist movement along with OB-GYNs need to push it, not as THE method of BC, but as an equal alternative to the Pill for the many women who hate taking hormonal BC daily. Doctors can and DO put IUDs gladly in women without children–I got mine in at 19, with no other reason than “I don’t like the Pill; I want something else.” We need to promote information for both women and doctors to raise awareness of the new standard of care. Women have the right to pick the method of BC that’s right for them.

    1. The standard of care is no longer to refuse women without children getting IUDs because the new generation of IUDs is so safe.

      Interesting. That has not been my experience, nor the experience of several of my friends. We’ve asked for IUDs and basically been refused.

  10. IME, doctors who will give IUDs to twenty-somethings aren’t that rare. They may not suggest it as a first line option, but that doesn’t mean that they won’t be receptive if you ask.

    Some doctors hesitate to recommend the IUD for women who’ve never had children because it’s a bit more of an ordeal to insert the device in someone who has never given birth. If you let them know that you’re prepared for that, there’s a good chance they’ll cooperate.

  11. I can remember the standard feminist line of the 1980s, which was that the pill was evil incarnate. Feminists were still reacting – understandably – against the high doses of hormones in its early versions.

    But it’s just wrong to suggest that everything profitable for Big Pharma is anti-feminist. Older low-dose formulations of the pill are off patent and can’t be generating big profits for pharma companies anymore. The pill offers substantial protection against ovarian cancer. It’s one of the safest drugs out there.

    That doesn’t make it right for everyone, but if it works for you, it offers tremendous freedom. The expectations we now have for escaping unwanted pregnancy are very closely linked to the advent of the pill.

    And there’s no form of EC that’s non-hormonal. Talk about pseudoscience – that’s the sort of misinformation that kills an author’s credibility.

  12. Hmmm, I think I find it problematic to frame the discussion as being for or against hormonal birth control.

    I’ve never used hormonal birth control (I’ve gone from always using condoms to using a diaphragm when in a committed, tested relationship – and by the way it wasn’t super inconvenient – to getting my tubes tied) and I have to admit that I do have sort of a knee-jerk reaction against hormonal methods.

    But I’m also aware that every single method out there has its problems. Apart from the inconvenience, diaphragms are used in combination with spermicides which can cause allergies and reactions. Hell, condoms give me road rash more often than not. IUDs fail spectacularly if they do fail and getting sterilized meant full anaesthesia for me (not to mention badgering the surgeon to operate on a childless 27-year-old).

    There simply is no perfect method.

    So, agreed: hormonal birth control is problematic for a host of reasons.
    Raising awareness of those problems? Absolutely.
    Pushing for more and better alternatives? Hell yes.
    Opening a wider discussion about *all* available birth control methods, with all their pros and cons? Working on it.

    But singling out one method and condemning it or making women feel guilty about using it? That’s a little short-sighted, isn’t it?

  13. Though I’ve never gone to a doctor for birth control, I know that Planned Parenthood in New York offers the IUD. I’ve talked to a clinician about getting it, and I think I’m going to do it in two months when my year-long pill prescription runs out. It’ll cost me (with no-insurance, self-employed) only $400 to get it inserted and lasts for 5 years, which is the same price for me as getting on the pill for a year ($265 for the Pap and exam, $20pill pack/month for 1 year= $240). Seems economical, safe, non-hormonal and worth it!

  14. Lindsay- that sounds a lot like my experience. Having tried a bunch of different brands of the Pill, and come to the conclusion that it doesn’t suit me, I did a bit of research, found out about the Mirena, found myself a doctor who is qualified to insert them (my own GP happened to not be trained to insert IUDs, and was a little wary of giving a 20-something, single nulliparous woman a reference- that’s cool, though, he didn’t try to warn me off), and, after assuring that GP that I was entirely aware of the fact that my insertion would likely be unpleasant, left with an insertion appointment. And yeah, the insertion sucked. But it took 2 minutes, and that was 2.5 years ago.

    As for this criticism of the Pill.. it seems a lot like scare tactics. As someone who finds the side-effects from the Pill to not be something I’m willing to live with on a constant basis, I’m well aware that it ain’t perfect. It doesn’t suit everyone, for a ton of reasons. However, hormonal birth control, as one of a variety of birth control choices that women can make? It’s a Damn Good Thing. And it’s led to things like the implant, and the Mirena IUD, which, again, are awesome BC choices for many women.

    Again, I’m all for a critical discussion on birth control. I think that the Pill isn’t without its flaws, and it’s a sad thing that women aren’t generally educated with more accurate, reliable information about forms of BC other than the Pill and condoms. However, if we’re talking about problematic forms of BC, I’d be far more likely to start with something like the Depo-Provera shot, which is known to cause godawful side effects lasting months and years- it’s the same drug used to chemically castrate sex offenders, for chrissake- and has been marketed overwhelmingly to groups of women who are already oppressed- poor women and WOC. Now THAT’S a drug I’ll criticise. The Pill? Is not without its faults, but has had an overwhelmingly positive effect. Living in a country where contraception wasn’t fully legalised until the 1990s, I’m all too aware of the improvements in quality of life, and ability to make our own choices, that women of my generation have that those only a decade or so older still had to fight for.

  15. I love the birth control pill. I’ve been on it, in one form or another, for 22 years straight now, and it’s been nothing but wonderful–including during times when I wasn’t having sex. Historically and globally, I know the pill has saved a lot of lives, literally and figuratively. That said, it’s not for everyone, and I also know people it hasn’t worked for. I really think this should be about ensuring all women (and men) have the opportunity to get the information they need to find what works best for them. This is mainly about education and information. None of it should be about demonizing any approach.

  16. I’d like to add to the childfree 20-somethings who got IUDs. I had horrible side effects from the Pill and Depo Provera, and a diagnosis of endometrial hyperplasia prevented me (at the time) from getting Essure. So I got a Mirena IUD (which works as birth control and helps with hyperplasia).

    As Lindsay Beyerstein stated, it may be a bit harder for a doctor to insert but my doctor honestly had no trouble with the insertion and I had pain that was the equivalent of two days of bad cramps. Not a big deal.

    It’s really up to women to advocate for their own choice of birth control and make sure you have a doctor who listens to you. As a childfree woman it took me some time to find a doctor who took my desire not to have kids seriously but it was totally worth it once I did.

  17. Speaking as someone who’s highly highly sensitive to hormonal birth control, emergency contraception is without a doubt, 100% hormonal – for me, it has the emotional and physical impact of taking a month’s worth of pills at once. It hits with a force that leaves my usually manageable mental disabilities suddenly very, very active. I avoid them at all costs.

    I’m glad she’s speaking out against birth control, but that’s very dangerous misinformation.

  18. Sorry – giving another perspective on hormonal birth control, not speaking out against it. Apologies for the problematic framing.

  19. A friend of mine from here in DC got an IUD without much hassle (and works for a Female Reproductive Rights agency. She is 23. To quote her directly via an e-mail, she says,

    “It’s an outdated idea to think that IUDs will not be granted to young women. Some practitioners won’t give them to young women but they’re just ridiculous. The reason some won’t do it is because of the idea that IUDs cause infertility
    which is not the case.

    It’s unclear to me if the old ones used to (some of them did, like the Dalkon Shield) or if it’s partially due to a misunderstanding about IUDs and PID. The chance of getting Pelvic Inflammatory Disease increases if you have an IUD and PID can cause infertility if it’s not treated BUT if you’re having safe sex and getting yearly exams, the odds of that happening are slim to none.

    Just don’t let infections go untreated PID is caused by untreated STIs, generally, but IUDs are safe and very effective and young women who don’t want to have children in the next couple of years are the PERFECT PEOPLE to be using IUDs. You don’t have to remember anything, it’s good for 5 or 10 years depending on the variety you get.

    No pre-sex prep (unless you have a new partner/are not monogamous). You should always be using condoms if you’re not monogamous, especially if you have an IUD”

  20. OH! Sorry to spam, but I also wanted to mention this part of my birth control experience.

    I’ve been using a diaphragm as a backup method to condoms/withdrawal for about a year now, and I love it love it love it. It’s not the most convenient thing in the world, but it’s been awesome for me and my partner. I also like being able to take it in and leave it out – for me personally, I’m not comfortable having a foreign object in my body.

    Another thing about the IUD that I haven’t seen addressed here: it’s prohibitively expensive. I have some class privilege, but when I looked into it (and I didn’t have a ton of trouble finding a doctor willing to insert it for a 22-yr-old with no children) the price tag was $500, which was way out of my range. There are payment plans, but it’s still a big big expense. It’s rarely covered by insurance too.

  21. Though their can be a lot of problems with the pill, it is still the best option for a lot of women, especially since an IUD can be difficult to pay for upfront. And I just wanted to mention, because a lot of the comments seem to imply otherwise, the Mirena IUD is a hormonal method of contraception. The Paraguard IUD is non-hormonal, but it can cause heavier cramping and periods. In fact, Mirena has progesterone in it, just like the Depo shot and the implants. That said, I actually think that generally, women are more aware of potential side effects of birth control than most people are aware of the medicine they take. I mean, how many people know the side affects of taking an antibiotics or over the counter drugs?

  22. –Moderator, sorry, use this version upon approval—

    Just another childless twentysomething who got an IUD….It’s true I wasn’t “offered” one at any point…I had to do my own research for what birth control was best, and for many of the common criticisms of the pill chose the Mirena, the IUD with a locally based hormone (it only affects your lady business). The other common IUD offered today in the USA is in fact hormone-free (it’s the copper one).

    While I also don’t believe anecdotes prove widespread trends, I think there are a lot of misconceptions about the IUD currently. If it hadn’t had been for another (childless twentysomething) friend of mine who got one, I still probably would have thought my best birth control option was the Pill. When I did make an appointment to talk about an IUD, the young female medical assistant shared that she had an IUD and that most of the other women she worked with in the medical profession used one as well. I can only speak for myself, but there was no stigma surrounding my IUD, it’s worked wonderfully so far (my doctor told me the reason why the IUD is so effective is the lack of human error involved), and I’m very surprised it’s not mentioned more in discussions about birth control.

  23. I saw mentioned Depo Provera in a disparaging way earlier. As someone who cannot take combined hormonal birth control (migranes w/auras are a contradiction) and couldn’t afford an IUD, I had the choices of the “mini pill” or Depo. I know many people experience problems with it, but let’s not throw the baby out with the bathwater– it works really really well for a lot of women. (Like me!) Its all about finding what works for you– not dictating what you think won’t work for other people.

  24. But there’s a reason feminists toe that line so strongly — it’s because of ongoing encroachments onto reproductive freedom, including birth control. To leave that out of the picture, and to pepper your interview with misinformation, makes the conversation less helpful and less productive than it could be.

    That is the reason I have a huge problem with Ms. Eldridge’s thesis. It’s like she totally forgets the social context this conversation takes place in. That ruins her argument for me; not to mention her claim that EC is non-hormonal, because it definitely is. I knew that within the first five minutes of being inside a Planned Parenthood for the first time. I mean, come on now.

    On a personal note, the only kinds of contraception I’ve ever used are condoms (in the past) and the pill (now). I take a very low hormone brand and I haven’t had any major issues. The other options (Depo shot, IUD, etc) are either not financially feasible or seem more inconvenient. I know a lot of women think the pill is inconvenient, but I have no problem with it. It’s like any other medication – you just take it.

    P.S. Thank you, thank you, thank you Planned Parenthood!! They are the only health care provider I have access to, and because of my income I qualify for donation-based care. If it wasn’t for PP, I would never see any kind of doctor. They are a serious godsend.

  25. 500 dollars may be a lot of money, but an IUD can be good for ten years– that is less than 5 dollars a month. It is cheaper than *condoms* for a lot of people. Although I do know, that poor people end up often paying a premium for being poor, because having money saves money, the IUD really is rather inexpensive. It just requires having money up front, which I am aware has class privileges there, but under 5 dollars a month is *very* cheap.

    My room-mate, 23 and no kids had no difficulty getting a copper IUD, and I plan on getting one myself very soon. I have the money now, but might *NOT* sometime in the next ten years, so I *really* want to get it in, then not have to worry about scrounging up money for monthly prescriptions, or even condoms, which add up. We have the same doctor, so I anticipate no trouble.

  26. I went to PP when I was 20 and told them I wanted an IUD. The doc said she had inserted them in virgins, and they were a great method of birth control. I made another appointment at a different PP and my NP told me my uterus wasn’t large enough since I had never been pregnant. I was terrifically sad. I ended up eventually on the Ring, which I like better. I had no problems with the pill- except I am that rare dumb bird who can’t seem to remember to take pills.

    Recently, my 17 year old sister- no babies- went in and got an IUD, and they didn’t bat an eye. She was nervous and wanted me in the room- not PP’s policy, but she insisted due to her severe learning disabilities- and they didn’t argue about it at all. For what it is worth, she is under the same insurance from my parents that I was when I was 20, and all that we were charged was the copay of $50, the same I would have been had I gotten it years before.

    It might be worth mentioning that I know of no other women my age with IUDs, but I don’t know that anyone has been refused one. I have two friends- one with a disorder that would make pregnancy a non-option, and one childfree woman- both have been refused Essure and tubals.

  27. I participate in a number of childfree communities online, and the general consensus about IUDs seems to be that while there are still doctors who refuse to insert IUDs into nulliparous women due to outdated information or flat-out myths, there are doctors out there that will do the insertion. How difficult these doctors are to find seems to depend a lot on location. Honestly, from my observations, I’d say that seems to be the biggest hurdle. Some areas seem to be very anti-IUD.

    The LiveJournal community cf_resources has a decent (although not comprehensive) list of doctors who have performed such services, so for other commenters who are having issues finding a doc willing to do the insertion, it might be worth taking a look.

    For my personal experience…

    Back in 2005, I went to the Planned Parenthood clinic in Boston because I’d been unable to find a private practitioner near me. I have migraines with aura, and I found out that they would not refill my prescription for a combined contraceptive due to increased risk of stroke, and my only options were the progestin-only pill, the Depo shot, or an IUD. The doctor didn’t push the IUD, but she did mention it as a strong possibility (and I am nulliparous); unfortunately, at the time, I didn’t understand them very well and was scared; I might make a different choice now, but the birth control I have works so well I don’t dare risk screwing it up.

  28. Jill – I’m surprised that you’ve had trouble getting an IUD. Many of my friends and I (all in NYC, all in our 20s with no kids) have gotten them no problem. It’s a great option, though definitely one that we were taught less about when our generation was first starting on birth control.

  29. I have also had issues with the pill. When I am on it, my periods actually get longer, heavier, and more painful (and I’ve tried about 6 different types over the past decade). Since getting off the pill, I haven’t had any issues until I needed a medication that was known for being harmful to fetuses.

    My doctor told me I had to be on the pill to receive this medication- I told her that I haven’t been with men for about 2 years and don’t plan to in the immediate future. My doctor still refused to prescribe the medication unless I also took the pill (she would also have accepted depo or an IUD, both of which I also refused). She didn’t think that condoms or even abstaining from PIV sex (or sex with men at all) was good enough.

    I can definitely see how the pill is both good and bad for women, and I support any choice a woman makes about whether or not to take it. I just wish that more doctors would listen to this type of issue.

  30. And there’s no form of EC that’s non-hormonal. Talk about pseudoscience – that’s the sort of misinformation that kills an author’s credibility.

    Just to clarify, since I don’t see it mentioned in the comments (though I skimmed before posting), while emergency contraceptive pills like Plan B and Next Choice are hormonal, copper-T IUDs like ParaGard are non-hormonal options for emergency contraception.

  31. Doctors will definitely insert an IUD in a 20 something woman who has never had children, there is no reason not to. How do I know? I match that description and I got one with no problem, my insurance even covered it. And when going over options with the doctor I brought this up (because of the ads on TV) and was assured that there is no medical reason not to, there might be a bit more pain upon insertion, but no big deal. Also IUDs come with either low dose hormones or none at all. Good option.

  32. Just to clarify, I didn’t mean to imply that the Mirena IUD is non-hormonal. It is. It’s just that I had bad side effects from the Pill and Depo Provera but (sor far, about two years in) have had no problems with the Mirena.

    The point about having the money for it upfront is a good one, though long-term it’s one of the cheapest forms of BC you can get. I was lucky enough to have health insurance that covered it when I got my IUD, but I don’t have health insurance now. If I still have to pay out-of-pocket when it’s time to get a new IUD in 2013, you can be sure my long-term boyfriend will pay for a share of it.

  33. While there are many benefits to the Pill, there are also many scientific studies examining the environmental damage that an abundance of synthetic hormones can do. It’s not all about the person taking it and how they feel about the effects it has on their body. There are other factors to consider as well.

  34. I’ve had a love/hate relationship with hormonal birth control over the years. And by “over the years,” I mean for the past decade and a half, since I began menstruating.

    I’ve always had debilitating periods (which in recent years has been diagnosed as adenomyosis and endometriosis). And various forms of hormonal BC were prescribed as a first line “treatment” for them. Which, yes, they’re cheaper and more easily reversible than, say, surgery or other hormonally oriented options (e.g., Lupron). And, during the time I was also relying on them for contraception, they had a “kill two birds with one stone” kind of appeal.

    But I also think a lot of my health care providers used BC pills (and patches and shots and rings) as a sort of substitute for actually diagnosing the root cause of the pain, which in turn led to a delay in obtaining appropriate pain relief. I was always told, “You’re on the pill for that,” as if it was a given that hormonal BC would alleviate dysmenorrhea, which never actually turned out to be the case for me. In reality, most types of hormonal birth control made my pain and bleeding worse because on them, I had zero cycle control and bled at least 21 of every 28 days.

    Here’s the thing (the first): It was amazingly difficult to convince my health care providers that hormonal contraceptives were Not the Thing for me. I was severely anemic from the bleeding — that a lot of docs deemed “occasional spotting, a harmless side effect**” — before there was an agreement that something else was in order. Even now, when I ask for an additional scrip for my pain medication, I have to remind my doctor about all the methods I’ve already tried because “hormonal contraceptives would really be much better.”

    While I’m aware of how much hormonal contraceptives have helped people, both with contraception and other aspects of reproductive health, I also worry that there’s idea — maybe widely held, maybe not; maybe totally believed, maybe not; maybe consciously processed, maybe not — that BC pills are a sort of “magic pill” that solves all contraceptive and menstrual related complaints.

    Because here’s the thing (the second): a part of me still believes that idea, or still wants to believe it. I’ve been off all hormonal contraception for 6 months and off the pill for just over a year — and I’m considering going back on it. There is a part of me that hopes — and has had that hope reinforced by a lot of talk (advertisements, discussions with health care providers, conversations with other people with endo and/or who take hormonal contraceptives) — that that “magic formulation” of BC pills that’s a good match for me really does exist: I just have to find it.

    ** I do think “occasional spotting” can be a harmless side effect. I do not, however, think “occasional spotting” accurately reflects what I was experiencing.

  35. Well, I’ve got yet another perspective on it all – I was prescribed the pill for wildly irregular periods as a teenager, at a time when I wasn’t sexually active. I’ve been on it for quite a few years, and I’ve definitely got to say that the hormones which can be dangerous to some (I actually knew someone who had issues with blood clots at a very young age as a result of the pill) are invaluable to others. What Eldridge really misses is that since everyone’s body is different, so a medicine – not even necessarily birth control – that can be harmful to one woman can be exactly what her mom or sister or best friend needs.

  36. “It was amazingly difficult to convince my health care providers that hormonal contraceptives were Not the Thing for me. ”

    YES. After a lifetime of maybe one yeast infection, my OB still felt that the fact that I was having them constantly, all month long, no matter what I was treated with, was certainly Not Because I Had Started the Pill. Even though the two events were concurrent. My OB made me try two Pill dosages, but even the lowest one gave me YI’s.

    In addition, I had what can only be described as *constant* PMS–sore boobs, cramps, raging mood swings.

    All of which made it a *very* effective contraceptive, because sex was completely off the table while I was on it.

    And then as soon as I stopped the Pill, both problems disappeared, magically.

    Tried the sponge, too…eh. Better than a condom, but way too noticeable with that giant loop hanging down.

    So my diaphragm, while not super-convenient, has been a lifesaver. What *I* worry about, actually, is that every few years when I get a new one, they seem to be harder and harder to find. That does make me angry, because I can’t tolerate a non-hormonal IUD (freaks me out), hatehatehate using condoms with my husband, and anything hormone-containing is just right out.

    All of which to say, we need the research to continue to improve. If there was a male Pill, my husband would be glad to try it and take the burden off of me. But it keeps getting delayed.

  37. My understanding of the issue with IUDs and nulliparous women was that the IUD was more likely to be expelled by your uterus if you’d never been pregnant, but other than that, they were not any more dangerous. When I was researching it (I used one for three years between kids and I LOVED it), the few women I encountered in various forums who had experienced a spontaneous expulsion were childless, but that many women who had never been pregnant have had good experiences with it. I never had a provider suggest one until I was pregnant and talking about contraception postpartum. I’m glad so many women who want them have been able to get them and hope that trend continues.

  38. Re: the Pill and feminism

    I had, overall, a good experience on the Pill once I found the right formulation for me, but I reached a point where I just didn’t feel comfortable using hormonal birth control on a really longterm basis. Some of this was that, for complicated reasons related to shifting insurance coverage, I ended up changing brands twice in a relatively short time period and was disturbed at the emotional/personality shifts I noticed. They weren’t drastic or violent but they were noticeable. It made me wonder if the “me” I’d been experiencing for the past four or five years was the “real me.” The other reason was that I simply felt unsure about the consequences of being on hormones for the better chunk of my reproductive years.

    I have, at times, felt that that latter sentiment is not particularly welcome in feminist circles because of the sense that it buys into antichoice rhetoric that the pill is “dangerous.” (Compared to what? would need to be the question to get the right answer.) I’ve also been told that wondering about the longterm consequences is essentially anti-science. But the truth of the matter is that all of us who use hormonal birth control are part of an ongoing experiment – not because Big Pharma is evil and indifferent to our health but because there’s just not another way to find out what it means to be on the Pill for 20 or 30 years. The most recent studies have shown that, on the whole, hormonal birth control is slightly beneficial, which is great news given that so many women use it for so many years, and even if the studies found that it was, on the whole, slightly detrimental, there might be many women for whom the benefits outweigh the risks and I would never argue that it shouldn’t be available. But I have experienced occasions where even asking these questions was not welcome, and I have known a lot of women who didn’t know they had options other than the Pill or condoms.

    Mostly, I think it sucks that we have to have these discussions in an environment where the very right to access contraception is constantly under attack.

  39. My mum tried the pill in the 70’s and had terrible side effects from it. I’m sure it was a pretty high dose of hormones compared to the pill that I got in the 90’s. I asked the doctor for a pill prescription and she gave me the lowest possible dose pills you could get: Trifeme and they weren’t too expensive either. I switched to Monofeme later on when I wanted to choose when to have my period (trifeme – varying doses of hormones depending on where you are in the cycle, monofeme – same dose every single day so you can take it continuously for a couple of months without having your period). I’ve been on monofeme ever since. It costs $20 for 4 months of pills. And I’ve never had any side effects.

    But I’m in Australia. I guess it’s different in the US.

  40. It’s weird to me that so many people who write about the issues with The Pill seem to think about it in terms of pill vs. condoms, or mention fertility awareness as an alternative method.

    Then of course you get into the comments sections and women are talking about diaphragms, the ring, and IUDs as well as tubal ligation.

    I feel like that’s something that makes these types of discussions seem a little out of date to me. I mean, she even mentions the Dalkon Shield in the context of a lack of innovation in the field of contraceptive medicine!

    Looking at the discussion here as opposed to the interview, it is so much more realistic and nuanced. Maybe “thinking critically about the pill” just doesn’t cover it anymore when it comes to this issue?

  41. I love the fact there are like zero men posting on this tread…what did we all tune out because it’s a pill women swallow, and we don’t have to give it a second thought because someone else is taking care of the BC? (it’s the little round blister pack thing on your sig. other’s nightstand, usually pink guys) Anyway, why not push condoms more? – they are quite effective – coupled w/ a backup EC (and the breaking condom thing – I have never had one break – so I am not sure how often that happens) There are no known side effects – you can get latex free ones too. I have never been super comfortable with the idea of people taking doses of hormones (though I am generally wary of long term use of medicines) – we’ve been using the pill as our primary method of BC for 10+ years now in a monogamous relationship and some of the side effect risks bother me – I guess we did not worry about them as much when we were younger – we knew about the breast cancer risks then (and they are low so don’t assume I am being alarmist here or anti-pill). I’ve always been pro-condom because of the STD problems in this country – especially after the abstinence only education for the past 8 years here in the USA.

  42. I love the Pill. I’m allergic to latex and adhesive, and I have physical and mental health issues that make an insertion or injection a frightening prospect (if I have a reaction, I can’t stop it/get it out immediately).

    The Pill is the safest, most practical kind of birth control for me. Thank God for that.

  43. I’m glad to see people talking about the difficulties of birth control. I bounced around on different type of birth controls for a year at a time, each having some bad side effect or another (a lot of them emotional/hormonal). I now have an IUD (just to add to the anecdotes, I’m a 20-something without children, and I got it at a university health center, at which its very popular and they can even give it to college freshman), and while I LOVE IT like many of the other people here, keep in mind that other people have terrible experiences with it.

    I think it’s funny that there’s this sort of magic involved with finding the right method/pill. My IUD went in no problem, some people experienced pain like no other. My friend and I were once on the same birth control but reacted in COMPLETELY different ways. I wish you could just KNOW what the effects would be, but that’s just not the case, our bodies are way too complex!

  44. I liked the Pill just fine from about age 20-26 – stopped me having somewhat irregular periods that kept me home from school/work a day or two each cycle.

    Then I found a breast lump. And another. They were biopsied and removed as my mother and grandmother had had breast cancer, and were declared “harmless,” but it was rough thinking about “what if…” while I waited for the biopsies and results.

    I don’t know if the Pill had anything to do with this; my gyno thinks more likely than not it didn’t, but she’s not unhappy I decided not to go back on it.

    Fertility Awareness Method, combined with condoms and a supportive husband, has been great. I’ve gotten to where I can predict when my period is going to occur a week or two out and can relax when I feel a sharp pain, knowing that it’s normal ovulation, not something I should be concerned about. I feel like I know better what’s going on with my body, rather than just along for the ride.

    I think people ignore to what extent FAM can be used to help make reproductive/sexual decisions – it’s not just for people who won’t use any “artificial” birth control. Ok with a little risk? Only use condoms when you have a good chance of being fertile. Cannot tolerate even the risks of normal condom/diaphragm usage? Abstain during possible fertile times, use barrier method the rest of the cycle in case your analysis was wrong.

    It’s unfortunate that FAM is so tied in with religiously-mandated Natural Family Planning. But I guess like so many things, it’s a tool that can either be used for women’s empowerment (inexpensive, self-knowledge, wider range of choices) or continued subjugation.

  45. Hey Jill, Thanks for posting about the interview. I have clarified the point about Emergency Contraception on the Bitch Blog. In my book I have a chapter on non-hormonal methods (diaphragms, IUDs, condoms) and a SEPARATE chapter on emergency contraception, which is of course a hormonal method. I also talk about the pill in my book (which is absolutely great for many women. I say that from the beginning) and the alternative distribution methods (the shot, the patch, the ring, etc.) There is a chapter on fertility awareness, which isn’t right for many women, but I think is a method that we have the right to know about. I think it’s interesting that there is such fear about it that feminists don’t even want to talk about it. Also included in the book is a chapter on why we don’t have a “pill” for men, birth control and the environment, the role of the United States in global reproductive policy, and general contraceptive history. I just want to get women talking because (while it is an amazing tool) I think the pill has been the beginning and the end of our contraceptive conversation. We should be speaking more comprehensively about our options, and also acknowledging that the “best method” for a woman may change over time.

  46. I haven’t read all the comments, so I’m not sure if this has been brought up. I went back on HBC (Apri, which is a monophasic pill and it treating me much better than the triphasic pill I was on in college) to treat and prevent ovarian cysts.

  47. “While there are many benefits to the Pill, there are also many scientific studies examining the environmental damage that an abundance of synthetic hormones can do.”

    Which would be a really excellent argument, were it not for the fact that industrial polluters are currently dumping so many of those synthetic hormones into the environment that finger-wagging at women using HBC like they’re going to ruin the planet is something of a grim joke.

  48. One more thing: I am not an opponent of hormonal birth control. Not at all. I just think we should be able to talk about it.

  49. There are no known side effects – you can get latex free ones too.

    Henry, I’m glad that you seem not to have experienced side effects with condoms. They do, however, make it difficult for my partner to maintain and erection or reach orgasm, and they (including non-latex varieties) make penetrative sex painful for me.

  50. Which would be a really excellent argument, were it not for the fact that industrial polluters are currently dumping so many of those synthetic hormones into the environment that finger-wagging at women using HBC like they’re going to ruin the planet is something of a grim joke.

    Just because there are also other chemicals and people and corporations who use them irresponsibly and dangerously does not mean that we should cease dialogue about the environmental dangers of one of the most commonly used pharmaceuticals.

    It’s not as though valid scientific studies should be declared null and void because some people are hypocrites.

  51. Hi there – I’m the writer of the blog in which this interview appeared.

    I am surprised by your assertion that Laura Eldridge is ‘irresponsible’, or ‘clueless’ and your suggestion there are issues ‘left out of the picture’ – you criticize her for not contextualizing her remarks with discussion of the conservative push to limit reproductive freedom, but you yourself do not contextualize your discussion by saying this piece is part of a series of blog posts under the banner Reproductive Writes in which this topic has been discussed extensively, or that this interview works as an introduction to a book in which I am positive Laura covers this topic, nor do you contextualize Laura herself within the body of work she has produced and her decade-long career. As a journalist I would hope you would know about the limitations of including every side of such a complicated issue within word limit boundaries.

    I am very suspicious of being told that there is ANY benefit in NOT talking about the downside of the Pill. Many, many women suffer from side effects from the Pill. Many, many women have the quality of their lives significantly deteriorated by the Pill. A lot of these women spend a long time having no idea that they might feel unwell because of the drug they’re taking each day and suffer as a consequence. I think it is very important to discuss the Pill critically. I don’t see how letting the religious right control the argument is in any way an honorable stance to take.

    By all means add to the discussion here, and make the comments you see as necessary additions to the argument, but don’t bash someone’s knowledge and work because they don’t cover everything you feel should be covered. I am sure her book will – and the purpose of this interview was clearly to introduce the book.

    1. Just want to add, Laura, that I appreciate the clarification.

      Holly, no one was saying that we SHOULDN’T talk about the downside of the Pill. Who said that? Where? What I’m saying is that we should talk about our experiences and the downsides of the pill and what could be better, but that we need to do that without buying into the anti-science knee-jerk tropes that the right wing anti-choice movement employs. Your website makes it pretty clear that you do buy into a lot of those tropes, and that you have a very particular agenda that you’re pushing. Which is perhaps why the interview with Laura read the way that it did.

  52. I’m one of those women who cannot take hormonal birth control. I have mental health issues, and last year I went on the lowest dose on the market. I became psychotically depressed, couldn’t leave my room, crying uncontrollably and feeling horribly sick. Apparently this is a relatively common reaction for women with OCD and depression, and I do not tolerate drugs of any kind well at all. (although I choose to deal with the side effects of my psychiatric drugs, even though they make me physically ill and require me to sleep about 12 hours a night.)

    At least I didn’t inherit my mother’s latex allergy.

  53. I am surprised by your assertion that Laura Eldridge is ‘irresponsible’, or ‘clueless’ and your suggestion there are issues ‘left out of the picture’ – you criticize her for not contextualizing her remarks with discussion of the conservative push to limit reproductive freedom, but you yourself do not contextualize your discussion by saying this piece is part of a series of blog posts under the banner Reproductive Writes in which this topic has been discussed extensively, or that this interview works as an introduction to a book in which I am positive Laura covers this topic, nor do you contextualize Laura herself within the body of work she has produced and her decade-long career. As a journalist I would hope you would know about the limitations of including every side of such a complicated issue within word limit boundaries.

    Seriously? I should read a decade of Laura’s work before I can comment on a published interview that she did? That’s… not how this works. And yes, I understand the problems with word limits. But I also think there are serious problems with suggesting that EC is non-hormonal, or ignoring — in this interview that was published in a big feminist online magazine — the anti-choice war on birth control. Even if those issues were addressed elsewhere, you can’t realistically think that all (or even most or even many) of the people who read this interview will have read Laura’s entire body of work. So criticizing the lack of context offered in this interview is totally valid.

  54. By all means add to the discussion here, and make the comments you see as necessary additions to the argument, but don’t bash someone’s knowledge and work because they don’t cover everything you feel should be covered.

    I wasn’t bashing anyone’s knowledge for not covering what I felt should be covered — I was criticizing a statement which, as I read it, is factually incorrect (that EC is non-hormonal). It may have been a mistake in transcribing the interview, or perhaps the phrasing was just poor, but it nevertheless reads as factually wrong.

  55. “Anyway, why not push condoms more?”

    Henry,

    While condom use is very much a wonderful thing in many circumstances, relying solely on condoms is not a very wise thing for many women to do. Many women are not in a position to negotiate condom use. In other words: Many women have partners who refuse to use condoms and they are not in any position to leave that partner or refuse sex to that partner. Plus, the woman in question needs to trust that the man will wear a condom each and every time. It is also helpful to know that the man actually knows how to use the condom effectively. Besides that, condoms can break or come off during sex. This is something I’ve had happen on a number of occasions. I’ve personally always used some alternate form of hormonal birth control for that reason and due to the fact that I really, really do not trust men to take full responsibility for not getting me pregnant (even men that I’m in a long term relationship with). The problem of unwanted pregnancy is thankfully no longer a problem for me since I’ve had a tubal ligation, but for most women, worrying about pregnancy tends to be the most overwhelming concern when it comes to PIV sex. Or at least that has been my experience.

  56. Another nulliparous twentysomething IUDer here. I will admit to being privileged out the yingyang – I work at a university attached to a hospital with one of the most active women’s health programs in the region, so between the high population of young women and the high-level knowledge of women’s health needs, there was little chance I was going to run into an underinformed provider. My GYN just gave me the boilerplate rundown of benefits and potential complications, and once she was satisfied that I was informed, she got to it.

    I dearly love my Mirena IUD. I did perfectly well on tricyclic HBC, but it’s nice not to have to think about a pill, and my boyfriend and I are both a lot more comfortable knowing that it’s statistically effective and not really subject to operator error. It did hurt like a motherfucker for four uninterrupted hours after I got it – it was the only time I’ve ever vomited from pain – but it hasn’t caused me a bit of trouble since.

  57. My feelings on Hormonal birth control: I take a low-dose hormonal pill to regulate my period (I have a really weird immune disease that makes me horrifically ill during the last two weeks of my cycle). Before the version I’m on now, my previous doctor proscribed me something that made me even worse, and I went off the pill for over a year b/c it freaked me out and I was afraid. Then I found a new doctor that listened to me ( a rare experience, imo) and who proscribed me the stuff I am on now, and let me tell you, if I was broke, and it came down to not eating or not getting my next batch, I assure you all, I would be going hungry. But that is just me. I know plenty of women who get really sick on hormonal birth control, or who don’t like it for other reasons.
    On the note of EC as non-hormonal: a young woman in my care was told that somehow, and she took a dose (condom broke). She couldn’t be on regulative HBC because it caused heart palpitations, and so did the EC; I had to have her taken to an emergency room. So I think anyone who speaks on the matter should be very clear to categorize EC as Hormonal birth control so as to not cause such confusion.
    One last thing: Henry up there made a note about men taking more responsibilty for birth control. The only thing I have to say on that is that if I were in a long term relationship with a guy, LOOOONG before I considered sticking some plastic or metal doohicky in my uterus, we would be seriously discussing him going in for the completely reversible and almost perfectly safe snipping procedure. But that’s a decision every one gets to make on their own.

  58. After I realized the Pill gave me melasma and terrible overall rage, the Ring packed on 20+ lbs plus bouts of depression, I tried the Mirena as the lowest-hormone option. Neither my primary physician or the specialist who inserted the IUD tried to talk me out of it. I was in my late 30’s but had no children, and I’d heard the “if you don’t have kids you may get a long speech, etc etc” but no speeches from either one.

    Everyone’s experience is different, but the Mirena insertion for me was more than a little bit of discomfort. I was covered in sweat trying to hold onto the table and not fall off it, almost passed out when I tried to stand up, intense cramping afterwards (the body recognizes its a foriegn object and tries to expel it, hence the cramps) plus more bouts of depression, feeling generally bloated and swollen, and on top of all that terrible acne = Mirena removed after 6 months. I’m lucky that my insurance covered the Essure procedure in the same year as I had the Mirena inserted and removed.

    The Essure procedure was a cakewalk compared to the Mirena and I did notice a big difference going from the lowest level of hormones in the IUD to zero hormones with the Essure. And now when people ask when my husband and I are having kids, I tell them we’ve decided against them, and get the “well you never know, you might change your mind/get pregnant” response can say “oh yes I do know!”

  59. I’m actually confused as to why anyone would feel morally obligated to deny young, child[less][free] women an IUD. It’s removable. Yes, you have to go in to get it removed, but if you want to start a family and have children, I’m pretty sure that going to the doctor was already on the agenda, and this wouldn’t even be an inconvenience.

  60. Not so pleased that Pandagon wants women with negative birth control experiences to keep quiet. We’re either puritanical or anti-science? How about, we’re really sensitive to added hormones in our bodies? Why can’t we discuss this? Some women react very well, and some do not react well. The latter group is encouraged to keep quiet and pretend everything is fine.

    I personally would like the man to be on some sort of control. I can’t believe that feminists give so many arguments against it–those women can double up on birth control. I trust my partner and will deal with the consequences if I am wrong. I want male birth control!

  61. @Other- Just read the Pandagon article. The willful ignorance abounds. I want to throw her book in the garbage after reading that gleeful piece of avoidance garbage.

  62. Jill – firstly, yes that was a mistake in transcribing. There should have been a comma and two sentences were melded together. Blame me. Not Laura’s knowledge or understanding.

    I think your reaction to this interview is in itself ‘knee-jerk’ and that you yourself are clearly employing an agenda – an agenda you suggest is more legitimate because it has the backing of an entire political movement as far as you see it.

    My agenda – which, let me be clear, is to raise awareness about the potential side effects of the Pill on mood and well being so as other women do not have to suffer as I did – is not anti-science. In fact, if you read my blog, you would have seen it contains a whole lot of science about the health benefits of ovulation.

    I’m not buying into any tropes employed by the right-wing movement – in fact I’ve barely spent a year of my life in this country – and in the UK we have little contact with these tropes. I am making an argument that is for choice, for information, for open discussion and for women. What is happening here is that YOU are buying into these right-wing tropes and letting them blind you to what is actually being said about the Pill.

    Are you dismissing my experience on the Pill, and the experience of many women who I have spoken with, as unhelpful to the feminist movement? Are you suggesting we should not talk about our negative experiences for fear the right-wing might hear and take note?

    I take painkillers and asthma medication by the way, how’s that for anti-science?

    My reaction is far from knee-jerk – it took me ten years of taking the Pill to come to conclusions I have. It is a shame that the religious right is able to keep my conclusions from being considered sensibly. I discuss this at length in my blog.

  63. “and a SEPARATE chapter on emergency contraception, which is of course a hormonal method. “

    Tori’s comment has been oddly ignored in this thread, and this half-truth repeated since at least a couple of times.

    Emergency contraception is not “a hormonal method”, nor is it a single method at all. There are various EC protocols, only some of which are hormonal.

    The copper IUD as EC has the added features of (a) providing ongoing contraception; and (b) being effective up to five days after PIV intercourse, not just three days as with progestagen-only methods (Plan B, Postinor-2, etc) and the now obsolete Yuzpe method (an oestrogen + progestagen). Yet the IUD is frequently ignored in discussions about EC, even discussions by sources purporting to be authoritative.

    Mifepristone (RU486) can also be used as EC, and while it is obviously a hormone-receptor-disrupting drug, it is not technically a human hormone itself. Whether it should be labelled a “hormonal method” could be contentious.

  64. The only thing I have to say on that is that if I were in a long term relationship with a guy, LOOOONG before I considered sticking some plastic or metal doohicky in my uterus, we would be seriously discussing him going in for the completely reversible and almost perfectly safe snipping procedure.

    IUD and vasectomy aren’t comparable. Vasectomy reversal is only partially effective, and when it does work, sperm count and sperm quality is lower with a higher chance of birth defects in children sired after the procedure. It’s also very expensive.

    Don’t get me wrong: we need better birth control for men and women alike (and there have been exciting developments recently in male hormonal birth control), but the fact remains that women have more choice when it comes to contraception.

  65. Are you dismissing my experience on the Pill, and the experience of many women who I have spoken with, as unhelpful to the feminist movement? Are you suggesting we should not talk about our negative experiences for fear the right-wing might hear and take note?

    Again, WHERE did I say or suggest that? Damn. I said, very clearly in this post, that it’s a good thing to talk about the negative experiences we’ve had with the Pill. I don’t take the pill, for those reasons — it doesn’t work well with my body. Believe me, I am not suggesting that we don’t discuss the pill.

    But I am saying that in discussing the pill — including our problems with it — that we be realistic and that we base our claims in science and fact, not in “it made me feel bad so therefore it is a BAD THING AND ALL WOMEN MUST KNOW.” And yes, you have a right to your opinion and to your experiences. But in reading through your blog, I’m honestly shocked that Bitch had you guest-post (especially since most of your guest posts were anti-pill diatribes). Again, sharing your experiences? Great. Trying to universalize your experiences to a lesson that should be learned by all women, and ignoring medical and scientific fact? Not great.

  66. Alex (68),

    Thank you for telling me that. I had never seen that information. I had always been told that vasectomies were nearly 100% reversible. Of course, I have never been in the sort of long-term relationship that justifies researching them, but this is very interesting and certainly changes my perspective on that.

  67. Jill – I have not ignored medical and scientific fact. What is the medical and scientific fact you feel I am ignoring? Please elaborate. If you read my blog, you will see I talk a whole lot about the medical and scientific facts of the Pill, what it does to women’s bodies and how it works. A lot. I do think ‘all women must know’ the information I discovered about the Pill in the last year in order to make a truly informed choice about their birth control. I don’t think it’s fair for many women to think the Pill ‘regulates’ their periods. I just don’t. I am very realistic – if you see I have spoken to many experts in this field – it’s not just me rambling away on my own agenda – if you see there are many women, doctors, who have similar concerns. None of us are suggesting the Pill be banned. We are suggesting women should be aware of it’s potential impact.

    Why do you think women have bad experiences with the Pill, Jill? Have these bad experiences got nothing to do with medical or scientific facts?

    And as a feminist, are you aware of the structure of the medical industry, the pharmaceutical industry, the history of science and the position of women within all three areas? I am shocked by your lack of contextualizing here.

    It was once scientific and medical fact to say women who would not be obedient were ‘hysterical’ and needed to be put in asylums. It was once scientific and medical fact to say that a difficult woman should have her ovaries removed to calm and placate her. Need I go on?

    1. Holly-

      So… you rely on medical and scientific facts, except that medical and scientific facts have been used against women in the past and so you don’t rely on them. Ok then!

      Here is what I see you doing: Taking bits of information about the pill and blowing them up as a scare tactic, and then framing it as “just giving out information.” I see you saying that, for example, the pill is addictive — do you have any backing for that claim, other than “I felt addicted”? Yes, some women do have physical complications from taking the pill, but those complications are relatively rare when put in the context of the huge number of women who use birth control. To suggest that half of all women who use birth control experience “Depression, anxiety, paranoia, rage, panic attacks” because of the pill is irresponsible. Also, statements like this: “I don’t think it’s fair for many women to think the Pill ‘regulates’ their periods. I just don’t.” What does that even mean? I’m sorry you think that’s unfair…?

  68. Jill, I thought this was a great post, and was glad you wrote that it’s important to balance informed skepticism with the continued preservation of right-to-access.
    Some people have responded to you saying it’s difficult to get the IUD by saying they were offered Mirena. I just want to point out that while Mirena is technically an IUD, it is a hormonal method, unlike the copper IUD. The hormones are just dispersed through an implant in your uterus. Moreover, it is a brand-name product with a huge marketing push behind it–I’m not surprised doctors are offering this. I go into more detail on this issue here.

  69. I had a bad experience with low dose hormonal birth control. It made me feel constantly mildly depressed and irritable, sapped my energy, gave me brain fog (going off the pill and being able to think clearly again is more wonderful than I can describe), made me uninterested in sex (and often repulsed by it) and made me want to eat all the time. The symptoms crept up on me over the years, so I didn’t connect any of it with being on the pill until I went off it and it all went away. I think HBC is wonderful for those people who don’t have bad side effects (or who feel the 99% accuracy is worth enduring the side effects) but I do wish there was more cultural and feminist discussion around the negative aspects of HBC because…. nobody warned me those things could happen.

  70. Just because there are also other chemicals and people and corporations who use them irresponsibly and dangerously does not mean that we should cease dialogue about the environmental dangers of one of the most commonly used pharmaceuticals.

    Um, yes, yes it does.

    Because, in the real world context, this is absolutely blaming women for RUINING THE FISHIES!!! omg!! because they SELFISHLY WANT TO HAVE SEX WITHOUT BABEEZ, THE SLUTS!! eleventyone! Meanwhile the actual polluters are being pretty much ignored.

    Human beings have an impact on the planet. The impact caused by the birth of any one human being is vastly greater than the impact of the hormones his or her mother might pee into the water over her entire lifetime; birth control is actually an environmental positive in that it controls the population of the biggest threat to the environment there is, human beings. Also, the synthetic estrogens used in birth control are much more similar to the real estrogens that women who are *not* on birth control would pee out, or the testosterone (which breaks down into estrogen in the environment) that men pee out, than the breakdown products of plastics, which are everywhere, used by both sexes, and have *much* more negative effects and much longer chemical lifespans in nature than the byproducts of birth control pills.

    Talking about the negative impact of something that *women* do in order to avoid having children as if it is anywhere near equal to the impact of what corporations do, or even what most humans in our culture do (ie, our dependence on plastic and the fact that we don’t recycle it when we’re done), is like complaining that your girlfriend is sleeping late and is too lazy to make your breakfast, while your house is on fire. They’re not *comparably* bad, and since one is extremely gendered and is used disproportionately to shame women for taking care of their own health, while the other is a matter of convenience for both sexes and is rarely addressed, or is a matter caused by large corporations who have a great deal of power and very little shame, I think it’s irresponsible and cruel to even bother bringing the first one up.

    Now, if you want to talk about putting more expensive filters on the sewage system to keep out things like human hormones, that might well be a good idea… the concentration of human beings in cities is not something nature intended or can easily adapt to (I am not saying it’s wrong, btw — I’m very much in favor of urban life — but it is, literally, not natural), and the sheer quantity of human hormones in urine, male and female, could probably have some potential to harm the wildlife near cities. But shaming women specifically for taking extra estrogen, when we already *make* natural estrogen and pee it out, and when the estrogenoids caused when plastic breaks down are so much more ubiquitous, seems like the agenda is *actually* about punishing slutty women and not really about protecting the environment at all.

  71. She completely overlooks the fact that ALL MEDICATIONS get into the water supply and have an adverse affect on the environment–stuff for your pet, your anti-depressant, your cold medicine, your antibiotics, your cholesterol meds, whatever. People excrete it and they toss them away or flush them down the toilet when they aren’t needed. So I find this concern about the Pill to be. . .telling.

    Not to mention the fact that a lot of plastics mimic estrogen, and there is a lot more plastic out there than there is orthocyclene, etc. But then again, I’m one of those brazen hussies who’s on the Pill and am really freaking happy I have access to it. My periods are bearable, for one thing. It’s also nice to know that if the condom breaks, I’m okay WRT pregnancy. Compared to the affects of a multitude of unwanted children (who will end up consuming and using a lot of plastic products), the Pill’s affect on the environment is comparatively small.

  72. Geez, Holly, you sure are argumentative! I’m pretty sure we are all on the same side here! Unless you are advocating that NOBODY should take birth contol because for SOME people it has bad side effects.

    It seems to be the consensus that while birth control has great perks, it is important to consider that there ARE risks and side effects. That is all. Not everybody who takes birth control has side effects, and for those who do experience side effects they can vary– sometimes the side effects can be good.

    And to say that you “don’t think it’s fair for many women to think the Pill ‘regulates’ their periods” is ridiculous. IT DOES regulate the periods of many women who take it, but it also can have irregulating effects for some as well. If a woman is taking the pill and bleeding more often than not, that is a sign that she needs a higher dose of hormones or at least a monophasic one (which means that all the pills have the same dose of hormones).

    Personally, I’ve had good AND bad experiences with birth control pills. I’ve tried three different brands and I have finally found one that doesn’t give me bad side effects. The first one I tried was great at first– it regulated my periods, got rid of my acne, and I swear my boobs got bigger. However, after a while I noticed that I was getting REALLY moody, to the point of feeling HAPPIER while on my period, the week I wasn’t taking the hormones. I spoke to my doctor, and she gave me a lower dose pill. That worked wonderfully for awhile, too, roughly two years, until I started spotting more and more and eventually I was bleeding three weeks out of four, and to boot the moodiness came back. Again, I went to my doctor, and she switched me to a low-dose monophasic pill, previously I had been taking triphasic. I’ve been on that now for about a year and although I feel I’m just a bit moodier than I would be if I weren’t on the pill, it’s better than it has been in the past and I can deal with just a bit of moodiness. Heck, it probably makes me write better.

    It made me wonder if the “me” I’d been experiencing for the past four or five years was the “real me.”

    I’ve wondered that as well. I’ve been on birth control for the better part of the past 8 years. Although I’m pretty certain I’d be a little less moody if I weren’t on the pill, I would also be suffering from debilitating cramps once a month, like I did before I was on the pill. For me, it’s been give and take.

  73. It made me wonder if the “me” I’d been experiencing for the past four or five years was the “real me.”

    I know it’s a valid concern, but it’s also unpleasant to read things like that when you spent your entire adolescence on a variety of antidepressants… At least the pill is something you can hop back off of, unlike a lot of other mood-altering medications.

    I’m not criticizing this sentence so much as pointing out that it’s a little bit worse for some people and their drugs. People saying things like “the ‘real me'” was why I was so resistant, as a kid, to taking medications that ended up really helping me later.

  74. Bagel-san. Word on the anti-depressants. I spent my teenage years on them, and spent college on ADD medications. Haven’t taken one pill, other than B.C. since. My main problem with it, is that I can’t seem to take it consistently. I think I might go on an I.U.D after I become sexually active. My only worry is the pain..

  75. I agree with bagelsan and Politicalguineapig – I am very uncomfortable with the suggestion that meds that change the way a person feels somehow change who we are. I have taken meds that are specifically designed to change the way that I feel for many years. Is my authentic self the one that can’t leave the house because of her anxiety?

  76. @Alara-

    Now, if you want to talk about putting more expensive filters on the sewage system to keep out things like human hormones, that might well be a good idea…

    Better filtering of sewage systems would be a great start, while we figure out other, safer options for birth control and plastics and everything else that contaminates the water everyone drinks.

    Anyway, I don’t advocate for taking away people’s pills, ffs. I do, however, adamantly oppose the idea that we should be purposefully intellectually dishonest, which is increasingly prevalent in online feminist communities.

  77. It made me wonder if the “me” I’d been experiencing for the past four or five years was the “real me.”

    I know it’s a valid concern, but it’s also unpleasant to read things like that when you spent your entire adolescence on a variety of antidepressants… At least the pill is something you can hop back off of, unlike a lot of other mood-altering medications.

    I’m not criticizing this sentence so much as pointing out that it’s a little bit worse for some people and their drugs. People saying things like “the ‘real me’” was why I was so resistant, as a kid, to taking medications that ended up really helping me later.

    Just a note, with the passage in italics above I was quoting a previous post, as well as agreeing with the sentiment. I should have been more clear that the italics were meant as a quote, (which I WAS agreeing with) instead of emphasis. I’m new to the HTML game.

    I guess my whole point here is that the mood thing was a side effect of the BC, and I was just trying to relate to the previous post who said that about wondering who she “really” was. I did not bring up the effects of other drugs on the psyche and did not intend to, the discussion was limited to birth control at that point. I was referring to the fact that I don’t know how moody I would or would not be without the birth control because I’ve been on it for so long, which I think was what the previous person who said that was getting at as well.

    Also, I didn’t mean to imply that birth control is anything like other mood-altering drugs, I certainly don’t know personally what that must be like and I’m not trying to say I do. I was simply saying that the hormones in bc had the side effect of making me extremely moody and depressed, to the point where I have felt like I needed some sort of antidepressant. When I went off the BC pills for awhile, those feelings went away. I think it’s safe to say that since I immediately felt better after stopping the hormones, the BC pills were a causal factor.

    I guess the reason I’m defending myself so much against this assertion about what I said is that I completely understand where you are coming from. NObody can understand what mood-altering drugs must be like until they are on them; my mother is bipolar and schizophrenic and she takes certain medications, one which “levels” her out and another which prevents her from becoming delusional and/or psychotic.

    “Is my authentic self the one that can’t leave the house because of her anxiety?”

    Not at all, just as my mother’s authentic self is not psychotic and delusional. She has an imbalance of chemicals in her brain which, when not controlled by medication, cause her to become psychotic. When she IS on her medication, she is fine.

    It’s sort of like my niece, who has ADHD and is always reluctant to take her meds for that, but when she doesn’t she’s bouncing off the walls and can’t seem to control herself. Later in life, she will realize the science behind it all, that she has a chemical imbalance in her brain, which is not her fault and which medications can help, somewhat.

    I really hate it that there is this social stigma about mood disorders, like they are less of a medical condition than other types of chemical imbalances in the body. Nobody would look differently at someone with diabetes or hypothyroidism because they need medication to be able to get through the day. It would be so nice if the same were true about mood disorders.

    Sorry about the novella; I clearly need to get myself to bed.

  78. Anyway, I don’t advocate for taking away people’s pills, ffs. I do, however, adamantly oppose the idea that we should be purposefully intellectually dishonest, which is increasingly prevalent in online feminist communities.

    I await the outpouring of concern over the effects OTHER medications have on the environment–medications such as anti-depressants, erectile dysfunction drugs, heart medications, meds for high cholesterol, etc. But no, the focus is on the Pill and the terrible damage it does to the environment. It is not intellectually dishonest to point out that the problem is bigger than the Pill and that articles like these smack of shaming women.

  79. It is not intellectually dishonest to point out that the problem is bigger than the Pill and that articles like these smack of shaming women.

    You’re right. It definitely is not. It is intellectually dishonest, though, to use that as a means to shut down criticism of the Pill. Which is what constantly happens when this gets mentioned. Like right now, on this thread, titled “THINKING CRITICALLY about the Pill.”

  80. If that criticism was part of larger criticism of the pharmaceutical industry and the effects of the environment and not just, hey, let’s focus SOLELY on the Pill, I’d agree with you. However, pointing out a double-standard (the Pill is destructive, women should rethink–other meds? Eh) isn’t shutting down criticism.

  81. Well, it seems like we’re in agreement, for the most part. The thing is, I don’t come across anyone “in real life” who is extremely critical of the Pill who isn’t also critical to the same degree of rampant pharmaceutical usage (with a focus on prevention by way of accessible healthy options for food, excessive, etc.) and especially large corporations causing mass pollution. And these people, in my experience, are never the same people who want to restrict or police women’s sexuality, who are often sexually active themselves and choose other birth control options.

    Other than extreme references to the slut-shaming anti-choicers found online, and their corresponding links, I’ve never had the displeasure of encountering someone who was both right-wing Christian, anti-choice, and also pro-environmental awareness of any kind. Those people don’t use the environment to back up their claims that the Pill is responsible for… whatever they’re mad at that day. They use religious examples. And no critically thinking, “progressive” individual is going to give any credibility to what that group of people has to say about the environment. It seems this is really a different group of people you’re talking about.

  82. (with a focus on prevention by way of accessible healthy options for food, excessive, etc.)

    Weird typo– “excessive” was supposed to say “exercise.”

  83. I’m going to assume that the “doctors who won’t put IUDs in 20 something women without children” is based on US data. I’m a gynaecologist in the UK, and it sure as hell isn’t the case here. In fact, the guidance from the healthcare quango NICE, which makes evidence based recommendations on clinical practice, advices that we advocate Long Acting Reversible Contraception (LARC) for preference. This ties in with various government strategies to reduce the incidence of teenage pregnancy, so may be partly politically motivated.

    Of course, I appreciate that we have the privilege of having free healthcare at point of access in the UK. Also, we have no financial incentives in Family Planning these days to encourage us to pick the method we profit from the most rather than what is best for the patients.

    And you can get non-hormonal methods of emergency contraception. I’m currently sitting my Family Planning Diploma and I’ve noticed a huge emphasis away from the emergency contraceptive pill to offering copper-coils, which, by the data provided in the course, seem to be the most effective method of hormonal contraception and have the added benefit of continuing to offer contraception.

  84. Re: comments on “women” and the Pill: it’s not just women who are on the Pill. I’m on the Pill, and I’m not a woman. I know several other non-women on the Pill.

    Being in possession of a uterus does not make you a woman.

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