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Has medical advice on taking the pill been wrong all this time?

ByEve Miller

Feb 1, 2019

When the contraceptive pill, or ‘the pill,’ first came onto the market in 1960, it revolutionised women’s sexual freedom. Now, over 100 million women globally use the pill as a contraceptive method as well as a way in which to control and regulate their periods. However, new guidelines from the Faculty of Sexual and Reproductive Healthcare (FSRH) say that there is no health benefit to the traditional seven-day break when taking the pill. This new information will change the way women are recommended to take the pill and will allow them to skip their periods altogether.

Dr Jane Dixon from the FRSH explained to BBC News that “there’s no build-up of menstrual blood if you miss your break. And actually, for many women, it’s not convenient to have a monthly bleed when they don’t need one.” Beyond convenience, she also discusses the health benefits of not taking a break saying that “we know that quite a lot of women develop side effects in that week, like headaches and mood change.”

Back when it was first used, the dosage of hormones within each pill was significantly higher. Therefore, the break was actually welcomed by women who often suffered from significant side effects whilst using it. The technology was also new so some people felt safer taking occasional breaks, for their health as well as to ensure that they weren’t pregnant.

Another reason for the break, and one which is currently dominating headlines, is the inventor’s religious background and the so-called “Pope rule”.

John Rock was a devout Catholic, something which conflicted with his research into contraceptive methods. Evidence of the opposition of the Catholic Church to the use of contraception dates back to the second century and their stance on contraception and abstinence has changed very little since then. Rock believed that the pill could be a way of getting around this block as a “natural form of contraception”.

This was in part due to the fact that the active ingredient, progestin, is a hormone naturally released during ovulation. He also came up with the “Pope Rule” where women would take a seven-day break from the pill at the end of each month. This would allow a monthly bleed which Rock believed would appease the religious leaders. This was not based on any scientific data but rather in order to make the pill more palatable to the Catholic Church.

His tactic didn’t work, but by the time the Pope had formerly denounced the pill, this idea of three weeks on, one week off had already taken hold.

The public, however, still have varying views. Some say menstruation is natural and shouldn’t be shamed whereas others argue that women should be able to have control over their body by stopping menstruation if possible.

Giovanna Chester in her film Period: The End of Menstruation asserts that “women are not sick. They don’t need to control their periods for 30 or 40 years. We need to embrace what makes us women rather than suppressing it”. She discusses how within our society there is already a lot of shame around having periods, something which often stops people from discussing them or getting help if they need it. Young girls shouldn’t be taught that their periods are a bad thing as they are simply a natural part of life, she stresses in the film.

Although people agree that the shame around menstruation should be stopped, they also think women should have choice. A 2006 study by the Association of Reproductive Professionals found that very few women have an emotional connection with their period. For most people it is just an inconvenience, and one which comes with a variety of side effects ranging from cramping to nausea and headaches. In addition, the concept that a woman must bleed once a month in order to maintain her “womanhood” is an idea which actively excludes those with medical reasons for absent menstruation as well as the transgender community.

These debates are important but the big question being raised at the moment is why, for almost 60 years, has the medical information around the pill changed so little. Alice Howarth said to the Guardian that, “Studies have shown repeatedly that our medical system has an inherent bias against women. Women presenting with pain are more frequently given sedatives than painkillers, where men are given painkillers. Women with coronary heart disease have delayed treatment compared with men. And people even rate the perceived pain of a paediatric patient differently, depending on whether they are told the patient is male or female.”

These issues stem from gender discrepancies within research. Only third of cardiovascular clinical trials are done on women despite it being the number 1 cause of death in the US and less than 45 per cent of preclinical depression studies involve female animals despite it being much more common in women.

The idea of blaming the break on the Catholic church makes an interesting story; however, in the long term this misinformation is due to a lack of studies. Two-thirds of women in the UK aged 20-24 take the combined contraceptive pill and yet research into it is sparse.

This lack of female representation within research poses serious threats to the health of women within our medical system. The scientific community desperately need to start recognising and fixing this problem because the pill is just one example of the way in which they’re failing women.


Image credit: Ceridwen-Commonswiki via Wikipedia Commons

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