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BCP

Feminism

hormonal therapy: medical treatment and birth control

On Monday, Rachel Held Evans ran “Why I Use Birth Control,” which featured my story with ten other women. What I wrote for her focused on the fact that I use the NuvaRing to manage my PCOS/endo and painful periods. I focused on that part of my story for a few reasons; first, it’s the only reason I’ve really had to use the NuvaRing up until recently, and second because the time in my life when I couldn’t afford it and had a cyst rupture was extremely relevant to what’s happening with the Hobby Lobby decision.

However, I’ve been married for a year and a half, and both I and my husband would prefer not to use condoms, especially since I’m allergic to latex and the non-latex options tend to be more expensive. We don’t have to, fortunately, because I have hormonal contraception that I tolerate fairly well. This reason is also important to talk about, because I don’t want to have children right now. I’m not even sure I want to have children at all, and I figure as long as we feel that way it’s probably a good idea to wait.

Handsome and I are in the position where having a child would be fine if I unexpectedly became pregnant. It would interrupt a lot of our plans and I wouldn’t be happy having a baby so far away from our families (I grew up away from my extended family, and I don’t want that for my children), but unlike Darlene Cunha, having a baby wouldn’t send us spiraling into poverty. But … we really don’t want kids right now, and we’re lucky that our health insurance covers the NuvaRing.

Jessica Valenti argued in The Guardian that “women like sex” and asked us to “stop making ‘health’ excuses for why we use birth control,” and she has a point. I want to have sex and I don’t want to have a baby: hormonal contraception is the perfect option for me, and I shouldn’t pretend that’s not at least half of the reason why I use it, and why I would continue using it if my PCOS/endo miraculously disappeared. The fact that most of the women who shared their stories on RHE’s blog focused on taking hormone therapy for medical reasons instead of as contraception also received some criticism, and I believe that is valid. If I could write my section again, I’d include “not wanting to have a baby” as one of the reasons why.

Conservatives, especially conservative Christians, the Religious Right, and the Christian fundamentalism that is so deeply integrated into the culture that Hobby Lobby is a significant financial supporter of are completely horrified at the idea that women might have sex without “consequences”– because that’s all a baby really is to them, a consequence and a punishment for a woman enjoying her sexuality outside of male control. They have no right whatsoever to assert their patriarchal system onto me and make my sexual choices for me, but oh do they ever desperately want to. For that reason, I believe that Valenti is right– saying “oh, but virginal, good women need BCPs for medical reasons!” isn’t going to do much when the conservatives and social regressives are obsessed with controlling what a woman does with her body.

However.

I don’t think we need to stop talking about the legitimate medical reasons why a woman or trans man might need to use hormonal therapy. It’s not a “health excuse”– it was the only thing that allowed me to function for the bulk of my life. And, personally, I am horrified that so many “Christian corporations” (I’m still in shock there is such a thing now, the whole idea is so essentially anti-Christ) are willing to sacrifice the health care of their female employees because of a completely unfounded belief about how hormonal contraception functions. That so many women desperately need hormonal therapy doesn’t affect them. Conservative Christian culture could not care less about women, and this proves it.

Conservative Christians want to make sure that women are punished, controlled, and enslaved by their uteri, and they are willing to sacrifice the health of every single woman who needs hormonal therapy to do it. They do not care about me, about the millions of other women like me. My pain, my suffering, means nothing to them when compared with their “deeply held religious belief.”

That’s why I think we need to talk bout both. Women deserve to think about if and when they want to have children, and they also are people with a specific medical need that deserves treatment options. That conservative Christians want to refuse us both says more about what their priorities are more than anything else– and loving Jesus and his children isn’t among them.

Update 7-17-14: Some have asked what I’m referring to when I say “conservative Christian.” Here on my blog I have chosen to use the terms “traditional theology” or “Protestant orthodoxy” to refer to theological conservatism, and distinguish between that and the theology of fundamentalism and evangelicalism. “Conservative Christian,” in the context that I have chosen to use it, refers to religiously-motivated social conservatism, as typically defined by socially conservative (and usually evangelical) Christians. If you identify yourself as a conservative Christian but you do not agree with those who would deny women necessary medical treatments and procedures, than the statements I’ve made here do not apply to you; feel free to disregard.

July 16, 2014 by SamanthaField

Feminism

how I learned to stop worrying and love the Pill, part two

Put in incredibly simple terms, hormonal birth control works thusly:

Step 1 : it prevents ovulation.

“Ovulation,” for the uninitiated, is when a mature egg is released from the ovary and become available for fertilization. “Prevents,” in this case, does not mean that the pill stops the egg from peaking its little head out of the ovary. It prevents because no egg develops to maturity. Simply put, there is no egg to come out of the ovary in the first place. This is one of the most important parts about hormonal birth control options, and something no one seems to pay attention to.

This is also the most important part for me. PCOS means that I get too many cysts developing at the same time, or they never stop developing, and I never experience a menstrual cycle. Ovarian cysts are normal– an ovarian cyst is where the egg matures. Hormonal birth control works to treat PCOS because it does not allow ovarian cysts to develop. An additional part of this process is that even if an ovarian cyst develops, there’s another chemical block in place that stops an egg from forming inside of it.

No ovarian cyst, no egg, nothing mature enough to be fertilized.

But, in the exceedingly rare case (if it wasn’t rare, it would be useless as a treatment for PCOS) where there is a cyst and an egg is developed, we move on to–

Step 2: eliminate the possibility of fertilization

This is pretty straightforward, and it comes in two steps. The progesterone in hormonal birth control options thickens the cervical mucus– makes it insanely more difficult for the sperm to reach the egg, which is already difficult– and it makes the egg harder to fertilize. So, even if a cyst develops, and if an egg develops inside of the cyst, and IF the sperm makes it up through the thickened mucus and all the way up the fallopian tube, when it reaches the egg, it’s going to have a hard time fertilizing it.

At this point in the process, the possibility of an egg being fertilized is so vanishingly small it’s not even really worth talking about, but I’m a-gonna, because it’s where the pro-life movement starts lying their little tooshies off.

“Supposed” Step 3: prevent implantation

At this point, the egg is a zygote, which is just the technical term for “fertilized egg.” For a lot of people this is where “conception” happens (which, problems), so this is where people start thinking that hormonal birth control is Just the Most Evil Thing those Evil Doctors have Ever Invented.

The most frequent term you’ll find in information about how this works is that the uterine wall is “hostile” for the egg. This is a misnomer. The uterine wall is exactly the same as it ever was, just thinner (hence, lighter periods). There’s no study that shows that the uterus becomes “hostile”– in fact, the scientific studies show that hormonal birth control options do not alter the uterine lining in any significant way except for making it slightly thinner, and are incapable of contributing to zygote failure (which I’ll explain).

This is the part where the pro-life movement lies. Because, at this point, they claim that this where the Pill murders babies. Literally starves them to death. Because it takes a baby (zygote), and then refuses it the opportunity to grow. It never grows, the woman’s body never receives the signal that she’s pregnant, and then the uterus expels the zygote and the uterine lining: therefore, MURDER.

Ok, folks, this is where I have All the Problems.

Let’s talk about the zygote, the supposed “great red herring” of the pro-choice movement.

The zygote is a single-celled organism, which through mitosis goes through stages (blastocyst, then embryo). Over fourteen days, it has to develop into an embryo, and the embryo has to develop the conceptus in order to attach to the uterine lining. The uterine lining, at this point, must transform from the decidua to the placenta.

Hormonal birth control methods are incapable of terminating a viable pregnancy. They are designed, in an unbelievable number of unnecessary steps, to prevent fertilization from ever occurring. Not by turning the uterus into a baby-killing machine. That’s patently false, and a bald-faced lie. If a woman’s body develops an egg, the uterine lining is unchanged. If there aren’t enough of the synthetic hormones present to prevent ovulation, there’s not enough of the hormones present to affect the uterine lining. If there’s no egg, then the uterine lining is thinner, possibly, and that’s the only real difference.

It’s a complete misunderstanding that in the case of supposed “breakthrough ovulation” that the uterine lining is still thinner. It’s not.

Here’s what the pro-life movement also refused to discuss:

All the medical studies I could scrounge up reveal that 60, 70, maybe 80% of all zygotes fail to implant on the uterine wall, when the woman is trying to conceive and is not on hormonal birth control.

Let me say that again: as many as 80% of all “babies” never implant in the uterus completely on their own.

For those that do manage to make it, another 30% don’t survive the first few weeks.

Let’s do the math again: 72% to 86% of all zygotes, which the pro-life movement refers to as babies, “die” without any outside interference whatsoever. When a woman is not on the Pill, zygotes fail.

When a woman is on the Pill, there’s rarely ever a zygote, and when there is one, it faces the exact same rate of zygote failure as a woman who isn’t on the Pill. The upside? When a woman is using hormonal birth control, there are less zygotes. Somewhere in the ballpark of 98% less zygotes.

Let me make this more clear: if zygote failure is “murder,” and hormonal birth control options drastically reduces the number of zygotes, the number of failed zygotes (i.e.: “murder”) is also drastically reduced.

Tell me again how the Pill is evil?

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*Edit*

I wanted to include some information I have that might clarify my basic argument in this post: that hormonal birth control options don’t interfere with implantation. I’ve already made it clear that hormonal birth control doesn’t make the uterus as “hostile” place for the zygote, but I thought it might be helpful to explain why, biologically, this is so.

A menstrual cycle is just that: a cycle. It goes through three steps, or stages. The first is the follicular phase, where the uterine lining is thin. Thin, in the same sense that it is thin while a woman is on hormonal birth control. It is not capable of of allowing the conceptus to attach.

However, part of the ovulation phase is that ovulation releases a trigger for the uterus to begin the luteal phase, where the lining becomes thicker and the conceptus is able to attach.

If a woman on the Pill ovulates, this releases the hormonal trigger, and the uterine lining thickens because it enters the luteal phase. If she does not ovulate, the uterus does not receive the trigger, and the uterine lining remains exactly the same as it ever was.

You can read about this on wiki. Seriously.

June 20, 2013 by SamanthaField

Feminism

how I learned to stop worrying and love the Pill, part one

When I was fourteen, I was diagnosed with Poly Cystic Ovary Syndrome (PCOS). To cut a very long, and a very awkward, story short, hormonal birth control (also known as “the Pill”) is the only known treatment for it. It’s not a cure, but it works to mitigate the suffering for a lot of women who suffer with PCOS. But it’s the only treatment [edit: occasionally, blood sugar problems can be a part of PCOS, but not always, in my case it is not], because of how it works and what it does, but I’ll get to that in a bit tomorrow.

I had to start taking it at fourteen– the doctor said that if I wanted any chance of ever having children, I would need to take the Pill. And even then, she warned me, I’d probably still need to have a full-blown hysterectomy before I was thirty. If I didn’t take the Pill, everything would get continually worse and I’d need to have multiple surgeries just to keep it under control.

So, I went on the Pill, and I took it faithfully for the next three years. It got my hemorrhagic cysts under control, even though it continued to cause persistent nausea and daily headaches that could blow up into migraines at a moment’s notice.

I also didn’t tell anyone, not even my best friend, that I was taking it.

When I started college, I was faced with a pretty significant dilemma: how was I going to hide taking the Pill everyday from roommates and suite mates? My solution was to put the pills into a regular prescription bottle, but that only worked for about a month, until I got my prescription in the mail. Then I had to figure out ways to get the Pills into the bottle and then hide the packaging– it had my name all over it, so I couldn’t just throw it away anywhere. I got pretty creative, coming up with means to hide what it was.

The fact that I was worried about people finding out about me taking the Pill every day should tell you something. What in the world was I expecting them to think?

Well, for one thing, I was absolutely positive that if someone who didn’t know me very well found out about it, they’d just assume that I was a slut. And secondly, if the administration found out about it (which was not outside possibility, they cared an awful lot about intimate details concerning their students), if something happened, my character would automatically be in question. They’d be suspicious about me.

Because I had PCOS, and was taking the Pill to treat it.

But, I knew that having a “legitimate” medical reason for taking the Pill wasn’t going to change the way anyone had already decided to perceive me. If they found out I was taking it, I knew they would label me a slut, and there would be nothing I could do about it. I was on the Pill– it would be all the proof they needed.

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A whole bunch of years later, when I’d figured out that I didn’t give a damn about idiots who would judge me for taking the Pill, I was talking to a woman about some of the pain she’d been suffering. During the course of our conversation, I realized that she probably had PCOS, and when I asked her about it, she agreed– that’s what the doctor had diagnosed her with. For her, it had caused her to lose her job, and she’d been hospitalized several times because of cysts rupturing. The pain had caused her to miss church, to constrain her to her bed for days on end.

I asked her what the doctor had suggested for treatment, and her response was that he’d given her pain killers, but she was trying not to depend on them too much.

“You aren’t on any medication?”

“There’s not any real medication for this, though.”

“There’s the Pill,” I blurted out. “It can help.”

She stared at me, her eyes widening in horror. She leaned in close, and dropped her voice to a whisper, even though we were in my house and the only people around were friends. “You mean, the birth control pill?”

I nodded. “Yes. I’ve been on it for years.”

Again, silence, and her wild eyes boring into me. I watched her think about what I’d said, and I watched terror form. She was completely horrified by my suggestion. “Oh my goodness, no, I couldn’t. I just couldn’t. That would just be so . . . wrong.”

It was my turn to be horrified.

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I should make it clear that this wasn’t in my fundamentalist church-cult. This was from a woman who had grown up in “regular” Christianity. There was nothing extreme about the religion she’d been surrounded by. It was all pretty typical, run-of-the-mill Baptist stuff. And she was still so horrified at the very idea of taking the Pill that she refused to even consider it as an option, even though it is the only medical recourse for her condition.

This is One of the Many Reasons why I have a Serious Problem with the Pro-Life Movement.

Because, and not to put too fine a point on it, they lie to people, especially women. They have spread so many lies for so many years that when a woman could take the Pill to treat a medical condition, she won’t, because the only thing she knows about the Pill is poppycock and hogwash.

So, I present a Crash Course in What the Pill is, For Realsies.

First, the Pill is a really limited concept of birth control. There are so many different kinds of birth control, including Natural Family Planning (NFP), barrier methods (condoms, sponges, vaginal condoms, diaphragms), vasectomy, tubal litigation. For hormonal birth control, there’s oral contraception (the Pill), hormonal and copper IUDs (intrauterine device), Depo-Provera (the “shot”), OrthoEvra (the “patch”), and now things like the NuvaRing.

Some of these are long-term, like the shot or an IUD, lasting from a few months to a few years. The patch and the NuvaRing last for the month, usually. You leave it on or in, and take it off/out for a week to have your period. The Pill you have to take every day, which is a bit of a nuisance.

All of these methods work a little differently, but the one that the pro-life movement has spread the most lies about is hormonal birth control, so I’m going to focus on that tomorrow.

June 19, 2013 by SamanthaField