Friday, February 5, 2010

Courting

Occasionally I like to take a look at how the lawsuits against Bayer Schering Pharma and their birth control pill Yaz are progressing. Today, when I made my usual Google trawl, I came across a piece regarding the enquiries the lawyers have been receiving from women who did not suffer from blood clots or their consequential strokes and heart problems, but experienced the anxiety and depression that I had for a good six months before I realized what was happening.

I had been wondering if the lawsuits would expand to take in the effect Yaz can have on mood, but figured that they might find it too difficult to present and defend. For a start a lawyer is going to have to defend the woman against attacks on her lifestyle, drinking habits, any family history of mental disorders. It would be a difficult fight, considering how there's almost always someone who will have had depression or something that can be labelled as a disorder and how everyone has a bunch of defamatory stories in their past.

The medical evidence for why Yaz causes such extreme changes in emotional state is there, but in order to use that evidence the case would likely have to include the argument that all birth control pills have the capacity to change a woman's mood dramatically and that although Yaz's particular make up does add a whole extra layer to the problem, the problem is still there potentially with all hormonal contraceptives. If Bayer Schering were to counter the case of a woman who has suffered mood changes by saying that all birth control pills have the capacity to do this, then they would be opening up the whole industry to a lot of questions. The woman cited in the piece, Sylvia, claims that Yaz caused her to have panic attacks, constant anxiety and difficulty controlling anger.

Of course she has to temper her complaint with the acknowledgement that her experience is not as 'serious' as a blood clot. This is understandable, but that level of anxiety can lose a person their relationship, their job and put much stress on their general health. The spectre of the Pill's ability to cause blood clots has long blotted out the other side effects. It is the one thing the doctor might have warned you about, and the source of the original concerns in the late 1960s about this newly released drug. When it comes to blood clots doctors and pharmaceutical company representatives can pull out all kinds of graphs to show how rarely they occur, how minimal the risk is and, most importantly, how improved the Pill is since its high estrogen ancestor Enovid. I assume they are having a little more of a struggle with this issue now that Yaz has upped the stakes. Also, I would think there's a possibility of more blood clot cases as more women in the US and Europe can be classed as overweight. But all in all, in comparison to the emotional side effects of the birth control pill, talking about blood clots must seem like a piece of cake.

To start talking about the emotional side effects of the Pill would not only reveal, in a court of law at least, the entrenched misogyny of the medical authorities understanding of women - bringing up all those ideas about how women are so suggestible and how they get depressed because their subconscious knows they can't have a baby when on the Pill or how women are just generally neurotic and hysterical and such is their natural state - but also shed a sharp light on how the pill actually works and the morality of shutting down women's reproductive systems and messing with their hormone cycles for a goal easily and safely met by other means.

The piece goes on to mention a woman who's daughter was put on Yaz and saw her 'entire personality' change. After taking the young woman to psychologists and counsellors she finally considered it might be the birth control pill. The mother says, 'We were told Yaz is the new 'miracle pill' - that it will make you lose weight, regulate your periods, clear up acne, you name it, it will fix it.' Bayer Schering made the mistake of advertising Yaz as a medication to treat anxiety, depression and tension, it marketed it as 'Beyond Birth Control' and as such made itself far more visible than other Pills on the market, far more popular and with much more to justify.

I am very glad that the horrible experiences of many women, including myself, on Yaz have caused this issue to be raised, but I am a little afraid that as Yaz has made itself stand out so far that young women will not think of it as the same as other birth control pills and will therefore not see that all birth control pills can impact badly on mood and well being. The problem with emphasizing the diuretic, potassium-sparing element of Yaz as the cause for the mood changes is that the only answer then given is to swap to another brand of Pill. Also the inevitable, and not completely false, emphasis on the Pill having a different effect on different women, allows the actual facts of the way it works to get brushed aside. All women should be aware that their emotional changes might be down to the Pill, not just those who take Yaz.

Since the blood clot cases came into the newspapers there is all kinds of talk on online forums about stopping Yaz, the withdrawal symptoms and how long these take to go away. Many of the women were completely seduced, as I was, by its skin-clearing, weight loss properties and struggle with the consequences of coming off it - often very painful acne and weight changes brought on by testosterone levels rising. It is worrying, although not surprising to someone who has felt just the same, to see women opting for clear skin and skinniness over emotional balance in their bids to stop taking Yaz. When you've been taught your female body needs medicating, and you can't help but find comfort in the control the Pill gives you over your body, it is hard, even when you feel like you're going crazy - or especially when you feel like you are going crazy - to know what is the best way forward for you.

We are, I think, often too keen to forgo our health. I guess we only think as much of ourselves as we told to, and the Pill is sanctified everywhere there is to look. It is also difficult in the current environment in which it is believed that we all suffer from stress and anxiety as part of modern life to distinguish whilst you are still on the Pill what is a normal reaction to life and what is a side effect. Once you come off the Pill you know for sure that there's a difference, but when you're on it, you constantly question every judgement as a consequence of feeling so detached from your self and the people, the world, around you. It is just as worrying that women get so little support from their doctors, who sadly seem to see the answer in more pills.

The Pill is not the appropriate way to deal with acne or heavy periods, it is not the moral or the compassionate way, but it is also not the appropriate way to approach birth control. It is a crude, primitive and aggressive medication that has absolutely no place in the lives of modern women. The Pill is not a cure-all, but it is also not just a way of preventing pregnancy. In doing that one task, it does a whole lot more to your body that is unhealthy and unwanted.

Tuesday, February 2, 2010

Missed Pills

Today I came across an article about a study conducted at the University Of Massachusetts that found that women who take in a good amount of vitamin D through foods, sunlight and supplements experience a 70% decrease in PMS symptoms. The study apparently focussed on women who felt their PMS interfered significantly with their lives. The research is part of a wider study into how vitamin D effects women's mental health as a whole.

This interested me as I have mentioned before how the birth control pill creates vitamin deficiencies through its impact on the metabolic system. When taking the Pill the body is unable to absorb the necessary vitamins, so although eating healthily is never a bad thing, it won't alleviate the effects of the Pill on your general health whilst you are still taking it. However, as I've also said before, getting a good lot of vitamins in general can help you overcome the withdrawal problems when coming off the Pill.

The emotional changes provoked by Pill taking can be traced back in part to deficiency in vitamin D. In flattening out the monthly rise and fall of hormone levels, the Pill could be understood as decreasing the possibility of PMS - which is effectively created by changes in these levels before menstruation. But, as many of us know, the Pill can make you feel as though you are experiencing PMS all the time. In fact, that is how my nightmare with Yaz began, starting out with what I saw as very bad PMS - anxiety, sensitivity, rage - around the time before my withdrawal bleed, and then spreading out over the entire month until I felt like that every day to a rapidly worsening level. And of course, because the feelings are not PMS as you know it, in that it is not predictably timed, nor is it moored to any kind of reality, it is frightening and debilitating.

Of course, there are other factors involved - the flattening of the hormone levels in itself, the lowering of testosterone levels - but vitamin deficiency plays a part in mood changes, along with increasing fatigue and generally feeling less than vital and well. Yaz in particular is mentioned in the article as a drug often prescribed to combat PMDD - essentially understood as a severe level of PMS. The piece points out that increasing intake of vitamin D is better than taking this Pill, as there are no side effects.

I have long wondered if the current sun-phobia that keeps everyone in the shade and under hats and on sunlight watch constantly due on fear of skin cancer has some part in the increase of depression and depressive problems. It sometimes seems like people have understood sunbathing with caution to mean never going out in the sun at all.

The article also raised some questions for me. First of all, obviously in its wording, and in the study's emphasis, the suggestion is that PMS not only exists as a 'disorder' or an 'illness' that needs treatment, but also that it is generally a negative experience that women do not want to have to undergo. Previously I have written about the invention of PMS as such, and how it came about at a useful time when it was necessary that women's abilities be undermined and women be sent into their homes to remain as homemakers and mothers, giving the post-world war two work back to the returning soldiers.

I have experienced what I would consider to be PMS I suppose, but rather than interfering with my life it appears to give me clarity on situations, and basically make me less tolerant of those situations that I feel are injust somehow. I just lose my patience with towing the line and keeping quiet and making compromises. I do get more angry than I normally would, and can see now into my fifth natural cycle off the Pill, that I get more intolerant of people around me. I can also see now that although my Yaz experience seemed like PMS spreading out over the whole month how I felt bear very little relation to real PMS which when it comes on, predictably, is actually pretty enlightening.

The issue here I guess is that there are women who experience extreme tension, anxiety and depression before their period - and I mean real period, not the fake Pill-induced kind - and they need to be acknowledged. There are also women who experience very painful periods who also need to be acknowledged. The Pill does not help with either of these problems however, but only masks the symptoms. It is therefore good to here that research is being done into possible treatments as alternatives to taking the Pill.

Increasing your vitamin D intake isn't going to hurt either way, and according to the study you'll still have 30% of your PMS to deal with. For ten years I was happily giving up my entire natural cycle and replacing it with the synthetic hormones of the Pill - now nearly five months off the Pill I have issues with even giving up the agitation and anger that comes just before my period. Despite my initial reservations, as I said my periods as a teenager were painful, heavy and pretty difficult, my cycle at 27 years old is a whole other experience.

As the study I cited found, young women's cycles take a few years to settle and regulate out. Prescribing the Pill to girls at fourteen is preventing them from finding this out, amongst of course a whole host of other things the Pill prevents. Perhaps if women were allowed to know more about their cycle and how their hormone levels change then PMS would be less intolerable in general, it would not be something happening to them, but something their body is doing that is natural, and possibly useful. I am not belittling any woman's experience, I am only championing the fact that the Pill really isn't the answer to horrid PMS or heavy periods and there are other options for dealing with this that should be tried out, or at least given a platform, rather than sunk beneath the promotion of the Pill as a cure-all.

I watched Diana Fabianova's documentary The Moon Inside You yesterday. It raised some subjects that I have not yet tackled here. I am always reluctant to come across as too hippy-ish when talking about women's natural cycles, periods and the like. Mostly because I am not at all hippy-ish and usually feel quite alienated by that sort of discussion. By which I mean the kind of discussion in which periods are celebrated and PMS is about female intuition and all women are connected to nature and we are special...And yes I completely acknowledge the reasons for why I may feel alienated by that talk, being that it is a sidelined perspective, likely deliberately undermined publicly and in fact called 'hippy-ish' in an effort to undermine its meaning. And yes it probably has a lot to do with how I see myself as a woman and how I understand being female, and how all that is certainly effected by living in a society that is hostile to femininity and female-ness. However, I also know that most twenty-something year old women feel the same and so I like to avoid going to far down that path.

That said, the documentary brought up how the social silence about periods - it was mostly about how women see their periods, and how society sees women menstruating - effectively isolates women from each other. We have all heard that anecdotal story about how women in the same college dorm, or the same shared house will eventually synchronize their cycles to have their periods at the same time. I have no idea if this is right, despite having attended an all girls' school for my whole teenage life, and a girls' college for one year, but even if it isn't there's something to be said for how the biological experience should make us feel some kind of unity. It is a shared experience, and it is something women do that men don't.

If we talked more openly about our experiences, rather than just placing them under banners such as PMS or using euphemisms, then we might find the natural cycle more interesting, feel more connected to our bodies and therefore our selves and our female-ness. Perhaps then we might feel more confident about being women and struggle less with the idea. But if this were to happen then it could be threatening to the status quo, and for it to happen we would need outside approval - like social acceptance. Or would we? Maybe women could come to the point without having to wait for society to decide that natural cycles are interesting, or even at least healthy, and that periods are not disgusting or dangerous. Perhaps women could do so by having a mass ditching of the Pill for good.

The documentary also pointed out that with each new cycle there's a possibility for reinvention inherent in the change. If you want to see it that way, you can, like the energy women can get after their period, which for some is a time of reflection, along with the PMS and its intolerance, could be seen as an opportunity for getting stuff done, and action and dynamism. It could be seen as a time to start afresh, with a changed perspective, or an altered perspective on what you want to do, need, and backed up the ability to make that happen. I can certainly relate to the change in energy, and the heightened level of concentration and clear thinking also.

This idea of change is the opposite of the status quo. By the status quo I mean the way things are in the world today - how society is structured, how women are treated, how women see themselves. The structure of how the world is necessitates for its perpetuation that we do not see the need for change, or at least the changes we see the need for are minimal (or rearranging the deck chairs on the Titanic as I like to say). Politicians may talk about change and gear people up with excitement about it, but real change is hard to come by, and when it comes down to it, most of the changes are poor substitutes for the real potential that exists. If things get to stay as they are, the people who are rich get to stay rich, the people who are poor get to stay poor and so on.

Essentially we could see women's natural cycle and that sense of flow and change that comes with it as threatening to the way things are. And if women were to become properly aware of that sense of change it could be even more threatening. If all the women on the Pill came off it and started to find their cycle interesting then perhaps that would be seen as a problem.

Aside that is from all the other problems it would cause - like all the money the pharmaceutical industry would lose. Women not on the Pill would be released from the depressive impact on their mood and well being, firstly. Then they would experience their natural cycle and maybe talk about it and maybe like it, and then they could see their reproductive abilities differently and start questioning how women's role in society has been created and the skewing of the understanding of these abilities. If coming off the Pill can be life-changing, as one commenter wrote here, and as I would agree, what does that mean when lots of women decide to stop?

The documentary went on to discuss the idea of collective consciousness as related to women's natural cycles. Consumerism is helped by isolating people - that's pretty basic analysis, but it's true. Isolated people buy more stuff. The Pill shuts down a collective experience. Collective experiences, and the collecting together of people, is essential to any kind of rebellion or change - in order in a sense for anything to change.

One interviewee in the documentary used very un-hippy-ish language to talk about the promotion of the Pill. He stated that the Pill was effectively society's way (and I really don't see it as men's way, because I think the economy and the structure although dominated by men, is not their 'fault' as such) of reprogramming women to fit into its established structure. The natural cycle is a source of change, flow, collective experience - it is connected to the natural world, to women's power in reproduction - and so society did not want to incorporate it, instead it had to be shut down, cancelled out, forgotten, sunk.

The interviewee also said that it was implemented in order to make women 'more like men' - obviously not quite how it works as men still get to have all kinds of natural hormone changes - but I can see where the idea is going. The masculine was acceptable, whereas the feminine was only faulty masculinity, or a disease. Masculinity and the appropriated traits of this, were understood as foundational to society - although it could be argued that the structure is based on inhuman (not male or female) elements. Either way, it initially needed to keep men dominant over women. Natural cycles were a threat to this on all kinds of levels. The Pill helped women enter the male workplace, and be accepted into the male world, but in disconnecting women from themselves, their bodies and each other, the Pill helped perpetuate the male-dominated social structure, by preventing awareness of potential for change and other ways of living, as well as prevention of awareness between women of themselves as a race.

I came across an article in the San Jose State University publication, The Spartan Daily, entitled 'Skipping the Contraceptive Pill: Rebel With Michelle.' I like the way the title turns around all the paranoia about women missing pills in a month which is inspiring this drive to get those women on to long-acting hormonal methods like the hormonal IUD, injection and implant. And I like the way stopping taking the Pill is being discussed as 'rebellion' as that is what it is in that Pill-taking has become socially encouraged, with women seeing the Pill as their only option and the only sensible, responsible contraceptive method to use. There is a situation to rebel against, an oppressive force that in stopping the Pill women are fighting against.

So, the article is written by Michelle Gachet who claims that the Pill turned her into 'an emotional psycho' as a result of the 'hormonal game' the Pill was playing with her body. Her decision to come off the Pill was influenced by her reading about the development of the male Pill. She decided she didn't want to be the 'only one in the relationship with the wacky crying episodes.' Michelle got frustrated with the fact that she lives in a world in which men get to ask, 'did you remember to take your Pill today?' as though it were normal, natural, required.

I am unsure of her feelings only in that I would in no way encourage the development of a male Pill and have no desire for men to experience the side effects such a drug would certainly hold. In my last post I suggested the suppression of libido that would occur is interesting to consider on a philosophical level - in terms of what such an impact en masse might bring about - but I would not, even in my anger at how women are pushed the female Pill - want the male Pill to be released on to the market. I do encourage discussion of the development of the male Pill, only as it encourages reassessment and consideration of how the Pill works on women's bodies and why the way it works, and what it is, is acceptable.

Michelle discovered the potential side effects by searching the Internet. I guess when you live in a country that charges an uninsured person around $200 just to sit in the doctor's office, let alone the additions for actually asking questions, the Internet is a great place to exchange information. I do encourage anyone to look at the boards on the medications.com and askapatient.com sites for comments about Yaz - it is the most complained about drug on the internet, a fact that only goes to support my view that open discussion of the reality of Pill-taking is systematically suppressed.

Skipping The Pill: Rebel With Michelle