Rethinking Reproductive Health

By Katie Singer

Recently, in a medical journal, I read that oral contraceptives are useful “in establishing regular menstrual cycles”1 for women with polycystic ovarian syndrome (PCOS). For years, I’ve observed that western medicine’s primary treatment of common gynecological problems is the birth control pill; still, I was dismayed to read this misinterpretation of what a menstrual cycle is and what oral contraceptives do to it.

A healthy menstrual cycle includes the maturation of about a dozen follicles, unripe eggs that emit estrogen; production of cervical fluid (which can keep sperm alive for up to five days); buildup of a new uterine lining; ovulation (also known as the release of one ripe egg, which will live for 12-24 hours); production of progesterone; and, when pregnancy does not occur, release of the uterine lining.

Oral contraceptives suppress many of these functions. The bleeding that occurs on the Pill results from taking sugar pills and withdrawing artificial hormones. This is not a menstrual period but a “withdrawal bleed” since it does not (with most prescriptions) follow ovulation.

Fertility drugs like Clomid, which are often prescribed “like water”2 when pregnancy is desired, hyperstimulate the ovaries to mature many more follicles than they normally do. In turn, the follicles produce three to four times more estrogen than they do in pretreatment cycles.

Are these pharmaceuticals dangerous to the women who take them? To their offspring? Are they changing the way we think about reproductive health? Are safer alternatives available to those who seek to prevent pregnancy or to become pregnant?

What can a woman do if she feels that her health has been compromised by taking the Pill or a fertility drug?

I imagine that people take hormonal drugs for several reasons: it’s become normal to take them; information about their hazards is usually posted in fine print; doctors (including alternative practitioners) are typically not taught natural methods of family planning in medical school—and they cannot give clients what they don’t know; and consumers frequently take prescription drugs and vitamins without researching their effects—because “they worked for my neighbor.”

Advertising is another factor. Barr Laboratories is currently engaged in a multi-million dollar campaign to promote Seasonale, their new oral contraceptive, which gives women “the convenience of only four periods [sic] each year” with just “all of the warnings and contraindications. . . identical to any other oral contraceptive.” There are currently sixteen million women on oral contraceptives in the US; Barr Labs aims to secure 90 percent of this market.3
Some Problems With
Hormonal Contraceptives

Oral contraceptives are made from artificial steroids that mimic the effects of estrogen and progesterone. The Pill works by:

* Suppressing the release of hormones that trigger ovulation;
* Stimulating production of thick cervical mucus, which prevents sperm survival and ability to travel to a ripe egg in the fallopian tube in the event that ovulation does occur;
* Disrupting the ability of the cilia (whip-like cells that line the fallopian tube) to move a fertilized egg toward the uterus in the event that conception does occur;
* Preventing buildup of the uterine lining, and thereby inhibiting implantation of a fertilized egg in the event that one arrives in the uterus.

It’s worth noting that the mini-Pill, a progestin-only pill, may not suppress ovulation or conception from occurring.5,6

In The Breast Cancer Prevention Program, Sam Epstein, MD, writes, “more than 20 well-controlled studies have demonstrated the clear risk of premenopausal breast cancer with the use of oral contraceptives. These estimates indicate that a young woman who uses oral contraceptives has up to ten times the risk for developing breast cancer as does a non-user, particularly if she uses the Pill during her teens or early twenties; if she uses the Pill for two years or more; if she uses the Pill before her first full-term pregnancy; if she has a family history of breast cancer.” Thus, a woman who takes the Pill for two years before she’s 25 and before she’s had a pregnancy to term increases her risk of breast cancer tenfold.

A study conducted by the World Health Organization found that women who carry the human papilloma virus (HPV) and who have taken the Pill for five to nine years are nearly three times more likely than non-Pill users to develop cervical cancer.7 (HPV affects a third of all women in their twenties.) Women with HPV who’ve taken the Pill for more than ten years are four times more likely than non-users to develop the disease.

Women who have a history of migraine headaches and who take combined oral contraceptives are two to four times more likely to have a stroke than women who have migraines and don’t take the Pill.8

Women who use low-dose oral contraceptive pills have a two-fold increased risk of a fatal heart attack compared to non-users.9 Women who take oral contraceptives and smoke have a 12-fold increase in fatal heart attacks and a 3.1-fold increase in fatal brain hemorrhage.10 Women who use the Pill after the age of 45 have a 144 percent greater risk of developing breast cancer than women who have never used it.11

Because of blocked hormone production, women who take the Pill have decreased sensitivity to smell. Because sexual interest is communicated through smell, the Pill may decrease women’s sex drives.12

In Solved: The Riddle of Illness, Dr. Stephen Langer writes that “the Pill. . . can cause severe bodily damage in hypothyroidism.”

Oral contraceptives may aggravate insulin resistance and longterm risk of diabetes and heart disease.13

Other hormonal contraceptives may also be problematic. Depo-provera, an injectable contraceptive, requires a shot every three months. Even one shot before a woman is twenty-one can result in bone loss. Adolescent women who use Depo may be more likely to suffer fractures when they reach menopause than those who never took the injections.14

Women who take Depo-provera shots for two years or more before they’re twenty-five have an almost tripled risk of breast cancer.15

Dagmar Ehling, a doctor of Oriental medicine, explains that “In its listing of the side effects of oral contraceptives, the Physician’s Desk Reference includes increased blood clotting, uterine bleeding, and carcinoma of the breast and endometrium. In Oriental medicine, these conditions could be categorized as Blood Stasis, a kind of ‘pattern of disharmony.’ Blood Stasis describes sluggish blood circulation, which might manifest as blood clotting, varicose veins, tumors, nodules or cysts. While acupuncture and herbs can address these conditions, from an Oriental perspective, the longer a woman stays on the Pill, the more she increases her risk for these kinds of problems.”

Many women taking the Pill have reported weight gain—a sign of estrogen dominance and/or insulin resistance—as well as depression and even psychosis.

If you have taken hormonal contraceptives and feel they have taken your cycles out of sync and negatively affected your health, eating a traditional diet with emphasis on vitamin A-rich foods, and sleeping primarily in the absence of light (a technique that I described briefly in the Spring, 2004 issue of Wise Traditions and more fully in The Garden of Fertility), has helped numerous women to return to health and normal cycles.
Assisted Reproductive Technology

In The Elusive Embryo: How Women and Men Approach New Reproductive Technologies, anthropologist Gay Becker describes couples who pursue their desire for a child “until emotional and financial resources are exhausted.” She observes that with the proliferation of assisted reproductive technologies, the emphasis has shifted from diagnosing and correcting abnormal physiology to achieving a pregnancy in the fastest and most direct manner possible, regardless of the cost or invasiveness. This approach aggressively augments the natural reproductive cycle, or bypasses it altogether, and aims for results regardless of the underlying infertility diagnosis.

If you are considering using reproductive technology to help you conceive, please first research its potential hazards—to yourself and to your potential offspring.

Clomiphene citrate, also known as Clomid, a common drug prescribed when a woman has difficulty conceiving, works by binding itself to estrogen receptors in the brain so that naturally occurring estrogen cannot be detected by the body. Clomid tricks the body into producing more and more Follicle Stimulating Hormone, causing more follicles (unripe eggs) to grow than normally would. In turn, more estrogen is produced by the follicles, and more eggs are matured. Typically, a woman taking this drug produces double or triple the amount of estrogen (and releases more eggs at ovulation) per cycle compared to pretreatment cycles. In Our Stolen Future, the pivotal work about how pesticides threaten animal and human ability to reproduce, Theo Colburn and her co-authors report that “numerous studies have linked estrogens, even those occurring in the body, to cancer, suggesting that the greater a woman’s lifetime exposure, the greater the risk.”

According to a package insert (available from your pharmacist, by request) about Clomid from Merrell Pharmaceuticals Inc., one of the drug’s manufacturers, “The majority of patients who are going to ovulate will do so after the first course of therapy. If ovulation does not occur after three courses of therapy, further treatment with clomiphene citrate tablets USP is not recommended. . . . If menses does not occur after an ovulatory response, the patient should be re-evaluated. Long-term cyclic therapy is not recommended beyond a total of about six cycles.” Merrell Pharmaceuticals also recommends that the first dose of Clomid be 50 mg.

Unfortunately, I know many women who have taken Clomid for as many as twelve cycles; I know others who took the drug at double the dosage recommended by Merrell Pharmaceuticals in their first use of it.

Essentially, Clomid hyperstimulates one aspect of the reproductive system—which then requires the rest of the system (which was perhaps out of sync before the drug was administered) to grasp for health and wholeness in response to being overstimulated.

Educate yourself as much as you can before using reproductive technology. Studies show that treatments like Clomid and in vitro fertilization (wherein conception takes place outside of the woman’s body) increase a woman’s risk of ovarian cancer (especially if she never conceives)16,17 and her offspring’s risk of birth defects.18-20 Also, Clomid can dry up cervical fluid, which makes it difficult for sperm to reach the mature egg easily.21

Leah Morton, a family physician, observes, “Some women want to be pregnant immediately once they start trying. I see this desire as part of a wider idea in our culture that we can and should be able to control our lives. We should be able to control crime, pollution, educational discrepancies, gender inequalities, our finances, and our fertility. Indeed, technology now may be used to help us control lovemaking, pregnancy prevention, conception, labor and delivery, even raising a child. But really, technological controls have nothing to do with fertility, with being in the unknown, the mystery of life. It’s up to us to respond to the joy, darkness, and awe that we experience.”

Dr. Morton also says, “If a couple is having difficulty conceiving or sustaining a pregnancy, my first concern is whether or not they’re eating food that’s not genetically modified, that is organic, whole and low glycemic (this means with little or no refined sugars or starches). Improving one’s diet is one of the hardest things to do in our culture. It also makes for healthier parenting!”
Real Women in the 21st Century

Most women in our culture have taken hormonal drugs at some point in their lives to prevent or achieve pregnancy; and, young women are commonly prescribed the Pill when they have acne, painful menstrual cramps, PCOS, and/or mild depression. Learning the hazards of these drugs can be discomfitting, to say the least.

I know very few people who have not taken some kind of risk-increasing drug. A while ago I read that women who have taken antibiotics every day for a year or more significantly increase their risk of breast cancer. What kind of dumb woman would take antibiotics every day for a year? I wondered—and then realized: a woman like me. As a teenager, I took antibiotics every day for probably two or three years to ward off acne. The drugs didn’t help, but all my girlfriends were treating their acne with antibiotics, and my parents and I didn’t know alternatives.

Indeed, when most of us experience some kind of problem with our menstrual cycles, or we want to prevent pregnancy, or we want to get pregnant, the most readily available option is usually pharmaceutical.

The good news is that there are alternatives. My first recommendation is to learn how the body works. If she learns Fertility Awareness and daily charts her waking temperature and cervical fluid changes, a woman of childbearing age can know whether she’s ovulating and whether she is prone to miscarriage, poly-cystic ovarian syndrome, low thyroid function and other problems.

If you identify a problem or a trend toward a problem, you may wonder what you can do to strengthen your health. Diet can be a great place to start. I know many young women who, in addition to discontinuing hormonal drugs, charted their fertility signals, identified problems with their cycles, gradually switched to a nutrient-dense diet, and found their health steadily improved. Indeed, in many of the groups he studied, Weston Price found that “girls were not allowed to be married until after they had had a period of special feeding. In some tribes, a six-month period of special nutrition was required” to ensure the health of a couple’s offspring.

Night-lighting techniques, herbs, homeopathy, or acupuncture can also strengthen reproductive health. So can meditation and yoga.

Regardless of the options you’re considering (for a health problem, to prevent pregnancy, or to get pregnant), research the risks and benefits involved. Keep researching until you find something that works for you.
The Six Steps of Healing

In the late 1970s, after studying scientific medicine, herbalism, various diets, homeopathy and other alternative healing methods, herbalist and author Susun Weed became increasingly confused—in regard to healing—about what to do first. Once she phrased her question, she realized the reply: First, do no harm.