Archive for the ‘Birth Control’ Category
Why Is Birth Control Use Declining in U.S. Women?
In late 2004, the National Center for Health Statistics released a report analyzing contraceptive usage in the United States from 1982-2002. The report discovered an interesting statistic — the percentage of adult women who had sex in the previous three months but did not use contraception rose from 5.4 percent in 1995 to 7.4 percent in 2002.
The increase was statistically significant and occurred only in adult women over the age of 20 — contraceptive use by teens was unchanged.
The Washington Post reported on the increase noting,
Because the survey is so large (more than 7,600 women) and known for its accuracy, “an increase of even two percentage points is worrisome,” said John S. Santelli, a professor of population and family health at the Mailman School of Public Health at Columbia University. Even as he cheered the news that a growing number of teenagers are using contraception, Santelli wondered whether doctors are neglecting women.
“Maybe we’re failing with women over 21,” Santelli said.
Much of the speculation about the increase centered around the possibility that women are finding the cost of birth control to be too expensive,
Jeffrey Jensen, director of the Women’s Health Research Unit at Oregon Health and Science University, said he regularly encounters patients who have trouble affording birth control, even if their private insurance covers it.
“It is absolutely unconscionable that women have a co-pay of $20 or $25 [month] for contraceptives and men are getting off scot-free,” Jensen said. Drug companies “have cut way back” on free samples and many women turn to less effective types of birth control because of cost, he said, “running a greater risk of pregnancy as a result.”
Not sure why Jensen feels the need to turn this into a men vs. women thing (men “get off scot-free”). The last time I checked, no major insurance company covers the primary male contraceptive — condoms.
Another speculation is that there was a decline in comprehensive sex education as the abstinence movement gained steam in the 1980s and 1990s. According to the Washington Post,
Several recent studies found that as the abstinence-until-marriage movement surged, there was a “considerable drop” in comprehensive sex education from 1988 to 2000, Santelli said. “Women in their twenties have probably gotten less effective information about contraception,” he said.
Or it could simply be a one-time outlier in the sample. After all, the difference between 1995 and 2002 women who had sex without using contraception was only 129 out of the 6,493 women 20 or over interviewed in the survey.
Sources:
More women opting against birth control, study finds. Ceci Connolly, Washington Post, January 4, 2005.
Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2002. Joyce C. Abma, PhD.; Gladys M. Martinez, PhD.; William D. Mosher, PhD.; and Brittany S. Dawson, M.P.P., Division of Vital Statistics. December 2004.
Netherlands Ends Free Contraception Program
The Netherlands recently ended its policy of providing free contraception to all women over the age of 21.
The free contraception policy, in combination with aggressive sexual education programs, was widely credited with the Netherlands having the lowest teenage pregnancy and abortion rates in Europe.
Teen pregnancy and abortion in the Netherlands has grown in recent years, but that increase is largely due to immigration — 60 percent of abortions in the Netherlands are obtained by members of ethnic minorities.
The government cited the high cost of maintaining the birth control subsidy as the reason for eliminating it.
Source:
Dutch abandon free contraception for all. Angus Roxburgh, BBC News, January 15, 2004.
Researchers Develop Effective Male Contraceptive
Researchers at the Anzac Research Institute in Sydney, Australia, announced in October that a small clinical trial of a male contraceptive found the drug 100 percent effective and side-effect free.
The trial involved 55 men who received a combination of implants and injections designed to stop production of sperm.
The men were given injections of progestin every three months. The progestin signals the body to stop producing sperm. It also shuts down all testosterone production, so the men were also given a testosterone implant that has to be replaced every four months.
When injections and implant treatment were stopped, the men’s sperm production went back to normal levels indicating the contraceptive effect is completely reversible.
Leader researcher David Handelsman noted the significance of the trial saying that,
This is the first time a reversible male contraceptive that will suppress sperm production reliably and reversibly has been fully tested by couples. This shows the way for a final product to be a single injection containing testosterone and a progestin which will easily be given by local doctors on a three-four monthly basis and still maintain male sexual health.
Larger clinical trials of the male contraceptive will have to take place before it reaches market, but this is likely to be fast tracked if these sort of results continue to hold up.
Sources:
Male contraceptive proves 100% effective. BetterHumans.Com, October 6, 2003.
Male contraceptive ‘100% effective’. The BBC, October 6, 2003.
Study of High Dose Oral Contraceptives Finds Low Death Rates
When the first oral contraceptives were introduced in the 1970s, they used relatively high doses of estrogen. Acting on the widely held view that lower doses of estrogen were safer, pharmaceutical companies gradually replaced the high dose pills with low dose versions. A new study of women who took high dose oral contraceptives, however, suggest that the concern over the high dose pills was misplaced.
Researchers at the Oxford Family Planning Association studied 17,032 women who visited family planning clinics in England and Scotland from 1968 to 1974.
Of the women how used high dose oral contraceptive, the death rate was actually 11 percent lower than for women who did not use high dose oral contraceptives. Due to the uncertainties in epidemic studies, that should not be read as implying that high dose contraceptives had a protective effect, but rather that their effect on the total death rate is not significant.
Which is not to say that high dose oral contraceptives might not contribute to some diseases. The study found that users of high dose oral contraceptives had much higher death rates from cervical cancer than non-users. But this was more than offset by a far lower risk of ovarian and other uterine cancers among users of high dose oral contraceptives.
The study confirmed that the major risk factor among the women in the study, both users and non-users of high dose oral contraceptives. Heavy smokers in the study had a death rate 100 percent higher than that of non-smokers.
Source:
Death rate low in former oral contraceptive users. Karla Gale, Reuters Health, July 18, 2003.
Tags: Scotland
James Madison University Decides to Ban Distribution of Morning After Pills
The Washington Post had an interesting story in April about James Madison University’s decision to stop the dispensing of the morning after pill in its campus health center after complaints from anti-abortion activists.
The health center had been prescribing and dispensing the morning after pills for eight years. Ann Simmons, a nurse at the health center, told the Washington Post that the Food and Drug Administration classifies morning after pills as contraceptives as opposed to abortion inducing drugs such as RU-486.
But Virginia State Delegate Robert Marshall sent a letter to James Madison University President Linwood Rose objecting to the distribution of the morning after pill. From there, a little politics was added to the mix.
James Madison University board Mark Obenshain is running for Virginia Senate. A local entrepreneur who supports another candidate distributed the letter to antiabortion activists pointing out that candidate Obenshain is a board member.
In April Obenshain then demanded an explanation about the distribution of the morning after pill and then successfully pushed the board to enact a ban on the contraceptive that passed 8-6.
Students at James Madison University obtained almost 3,000 signatures on a petition to ask the board to reverse its ban on the distribution of the morning after pill. That petition was taken up at the June meeting of the board which tersely reported that,
Neither the [Education and Student Life] committee nor the full board took any action on the request.
So for the moment, James Madison University students will have to go to off-campus pharmacies to have their morning after prescriptions filled.
Sources:
Pill ban gives birth to protest. Laura Sessions Stepp, Washington Post, April 24, 2003.
Summary Of Action By JMU Board Of Visitors. Press Release, James Madison University, June 6, 2003.
Argentina Judge Bans Contraception
Argentine judge Cristina Garzon De Lascano ruled in May that oral contraceptives and intrauterine devices should be banned because they constitute abortion. According to the BBC, de Lascano ordered the destruction of all existing stocks of such medications and devices.
This is not the first time de Lascano has made controversial rulings related to reproductive health. In 2001, she ordered a ban on the morning-after pill, and in February ruled that Argentina’s laws protecting women’s reproductive health could not be applied in Cordoba province. She was overruled by a higher court on that last decision.
The BBC reported that Argentine health minister Gines Gonzalez Garcia vowed to fight to reverse de Lascano’s latest judgment, characterizing it as,
. . . absurd and based on the plea of religious fundamentalists, without consulting a single a medical academic at the Health Ministry.
Abortion is illegal in Argentina, but an estimated 400,000 women have abortions every year anyway.
Sources:
Argentine contraceptive ban ‘absurd’. The BBC, May 24, 2003.
FDA Asked to OTC Morning After Pill
Women’s Capitol Corp., which distributes the “morning after” pill Plan B, has filed a request the Food and Drug Administration to allow it to sell the drug over the counter.
Plan B has been available by prescription in the United States since 1999 and the privately held company has sold about 3 million Plan B kits. If the initial pill is taken within 72 hours after having unprotected sex, Plan B reduces the risk of pregnancy to around 1 percent.
Morning after pills are available in other countries, such as France, but the sale of such drugs even by prescription is controversial in the United States due to opposition from anti-abortion activists. Since Plan B works by preventing the implantation of a fertilized egg onto the wall of the uterus, some activists view it as little more than a chemical abortion.
A decision from the FDA on the OTC application is unlikely until sometime in early 2004.
Sources:
‘Morning After’ Pill Maker Asks FDA to OTC Switch. Kate Fodor, Reuters, April 21, 2003.
Easier ‘morning-after’ access sought. Rita Rubin, USA Today, February 14, 2001.
A Man’s Right to Choose?
A few weeks ago, on the anniversary of Roe v. Wade which gave women the right to make a range of reproductive choices, Glenn Sacks wrote an cogent summary of the arguments for a men’s right to choose. Sacks writes,
When a woman gets pregnant she has the right to decide whether or not to carry the baby to term, and whether to raise the child herself or to give it up for adoption. In many states she can even terminate all parental responsibility by returning the baby to the hospital within a few weeks of birth. Yet if she decides she wants the child, she can demand 18 years of child support from the father, and he has no choice in the matter. When it comes to reproduction, in America today women have rights and men merely have responsibilities.
. . .
The “Choice for Men” movement seeks to give fathers the right to relinquish their parental rights and responsibilities within a month of learning of a pregnancy, just as mothers do when they choose to give their children up for adoption. These men would be obligated to provide legitimate financial compensation to cover pregnancy-related medical expenses and the mother’s loss of income during pregnancy. The right would only apply to pregnancies which occurred outside of marriage, and women would still be free to exercise all of the reproductive choices they have now.
At the moment there is almost no support outside of the men’s movement for such ideas, but as Cathy Young noted in an article on this topic a couple years ago, it is a direct outgrowth of feminist claims about the importance of abortion rights. Young wrote,
. . . Advocates of choice for men like to cite a passage from a Planned Parenthood statement, “9 Reasons Why Abortions Are Legal”: “At the most basic level, the abortion issue is not really about abortion. … Should women make their own decisions about family, career and how to live their lives? Or should government do that for them? Do women have the option of deciding when or whether to have children?”
Substitute “men” for “women,” and it’s hard to deny that coerced fatherhood drastically curtails a man’s ability to make key decisions about how to live his life, including when or whether to have children with the woman he loves. Think of “A Dad Too Soon,” the young husband saddled with college loans, graduate school tuition, car payments and other expenses, and forced to give up a quarter of his earnings because he made a mistake as a teenager. (His admittedly one-sided narrative also suggests that the mother’s paternity suit was partly driven by vindictiveness: Having waited for eight years, she filed the claim days after his wedding.) Yet, in the eyes of Ann Landers and many others, he deserves only a stern rebuke. Pay up and shut up. You play, you pay. It takes two to tango.
. . .
Yet, by and large, feminists and pro-choice activists have not been sympathetic to calls for men’s reproductive freedom. “If there is a birth, the man has an obligation to support the child,” says Marcia Greenberger, co-president of the National Women’s Law Center. “The distinction with respect to abortion is the physical toll that it takes on a woman to carry a fetus to term, which doesn’t have any translation for men. Once the child is born, neither can walk away from the obligations of parenthood.” (Actually, a woman can give up the child for adoption, often without the father’s consent, and be free of any further obligation.)
Indeed, on the issue of choice for men, staunch supporters of abortion rights can sound like an eerie echo of the other side: “They have a choice — use condoms, get sterilized or keep their pants on.” “They should think about the consequences before they have sex.” (The irony is not lost on men’s choice advocates or pro-lifers.) Yes, some admit, it’s unfair that women still have a choice after conception and men don’t, but biology isn’t fair. As a male friend of mine succinctly put it, “Them’s the breaks.”
Clearly there are some inequities that need to be eliminated, such as relief for men who end up being fathers thanks to the fraudulent and/or criminal actions of unscrupulous women, as well as men who are forced to pay child support for children they later find out they are not biologically related to, but going beyond that opens a can of worms that warrants proceeding very slowly.
Source:
30 years after Roe v. Wade, How About Choice for Men?. Glenn Sacks, MensNewsDaily.Com, January 22, 2003.
Study Finds No Increased Risk of Breast Cancer from the Pill
A study of more than 9,000 U.S. women ranging from 35 to 65 has found no evidence that oral contraceptive use increases the risk of developing breast cancer.
A 1996 study published in the New England Journal of Medicine had claimed that there was indeed such an increased risk, but that was a meta-analysis of 54 different epidemiological studies.
In the current study about 4,500 women with breast cancer and 4,500 without breast cancer were questioned in detail about their use of oral contraceptives, including older contraceptive pills which some researchers have suggested might be more likely to contribute to cancer because of their much larger levels of hormones.
But, in fact, the study found no increased risk of breast cancer for women who had taken such pills.
Source:
Pill does not increase risk of breast cancer. Gaia Vince, NewScientist.Com, June 26, 2002.
Contraceptive Patch Coming Soon to Europe and the United States
The BBC reported this week that the European Agency for the Evaluation of Medicinal Products has approved a contraceptive patch that has already received Food and Drug Administration approval in the United States. Women on both sides of the Atlantic should be able to buy the patch with a prescription sometime later this year.
The patch contains the same hormones as the pill — though in lower concentration since it is absorbed directly into the blood stream — and needs to be changed once a week. The patch has been designed to withstand exposure to water such as from bathing and swimming.
Clinical research of the patch found that it has fewer side effects, a higher compliance rate than the pill (i.e. women were more likely to use the patch consistently than they were to take pills consistently) and is not affected by condition by problems such as vomiting or diarrhea which can cause the pill to be ineffective.
About the only caveat with the patch is that heavier women — those weighing in excess of 196 pounds — may not receive a high enough dose of hormones and it may not be appropriate for them.
Source:
Contraceptive patch set for Europe. The BBC, February 26, 2002.