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Please Explain: Birth Control

Friday, July 13, 2007

The earliest known female contraceptive device dates back to 1850 BC, when pessaries made of crocodile dung, honey, and sodium carbonate may have been the best option available to women. Chemical contraception has changed a lot since then. Today's Please Explain is about the chemistry of birth control. Dr. Rini Ratan is an OB/GYN with the Columbia Unversity Medical Center.

Guests:

Dr. Rini Ratan

Comments [6]

IR from Manhattan

It's a shame that such a lengthy discussion completely omitted a type of birth control that has been proven by numerous studies, including one by the World Health Organization, to be safe and effective. Fertility Awareness is a system by which a woman (who is not on hormonal birth control) can know on what few days of her cycle she is fertile. With this information, she can avoid pregnancy by simply not having unprotected intercourse on those days. She can also use this knowledge to achieve pregnancy, to gain insight into her health, and in general to be more empowered around her sexuality. Fertility Awareness, it must be said first and foremost, is NOT the Rhythm Method. The two are completely dissimilar, except in that they are both natural and require no devices or chemicals. But whereas the Rhythm, or Calendar Method, uses past cycles to predict future fertility, a premise which is inherently inaccurate, Fertility Awareness is based on present-day observation of the body, and thus reveals a woman's fertile status on any given day. A woman practices Fertility Awareness by observing and keeping track of 1, 2, or 3 "fertility signals," ie symptoms which outwardly reflect her hormonal status. These signals are the basal body temperature (taken first thing in the morning), the cervical fluid, or mucus, and the position of the cervix. A woman can be taught to practice the method in a few hours. When practiced perfectly, it is 97-9% effective. It is obviously not for everyone, in that it does require a significant amount of personal responsibility, but for women like Emily, who are dissatisfied with the usual array of methods, and for anyone who wants to be more in touch with her body, Fertility Awareness may be a very good choice. Unfortunately, it is a choice not offered or even discussed in most doctor's offices, and one that is thus unavailable and unknown to most women. For further information, please visit one of these websites, or check out the books I've suggested. Note that as Fertility Awareness is fairly unforgiving of mistakes, it strongly recommended that personal instruction be obtained before one begins using Fertility Awareness to prevent pregnancy. That said, the World Health Organization said that 93% of women can learn to recognize the signals of fertility after just one session with a teacher. (1)

www.fertaware.com
www.gardenoffertility.com
www.justisse.ca

Taking Charge of Your Fertility, by Toni Weschler
The Garden of Fertility, by Katie Singer

Note: Natural Family Planning is a version of Fertility Awareness that is typically taught and practiced in a Catholic context. The biology underlying the methods is identical. For further information on NFP, see:

www.ccli.org
www.boma-usa.org

(1) WHO (1977-1981) Multi-centre - Auckland, Dublin, San Miguel, Bangalore and Manila.
Fertility and Sterility 1981 Vol 36, p. 152ff; 1981 vol 36, p.591ff.

Jul. 22 2007 12:42 PM
mr. jOSE PEREZ from BRKLYN,NY

THE WORLD HEALH ORGANIZATION SAID THAT THE PILL IS THE #1 CARCINOGEN OF WOMEN IN THE WORLD.I DONT HAVE MUCH OF AN EDUCATION BUT I WOULD,NT TRUST ANY DOCTOR OR COMPANY THAT PROMOTES CONTRACEPTION ESPECIALY WHEN THERES MONEY TO BE MADE. MY WIFE AND I USE THE CREIGHTON METHOD. WHEN FOLLOWED CORRECTLY IT IS 99% EFECTIVE AND TEACHES A MAN NOT TO USE HIS WIFE AS A SEXUAL TOY.

Jul. 13 2007 07:13 PM
SK from Brooklyn

The last two comments may well be related, if my experience is anything to go by. I share this in case it helps some other woman out there. When I was younger, my periods were very irregular. I could go several months without getting a period. When I finally did get one, the bleeding would be very heavy and the cramps severe enough that twice I nearly lost consciousness from the pain. In the months in between, I put on weight, despite my best efforts to control it, and started going bald. After the loss of consciousness events, I went to see an OBGYN. He explained to me that women produce male hormone and then convert it to female hormone...or something like that. Anyway, it seemed that my body would forget to do the conversion. The build-up of male hormone would cause me to beef-up and lose hair (not surprising as the men in my family tend to be bald). Eventually, my body would convert the hormone - all of it, all at once. At that point, I would experience the severe period. The doctor put me on the pill to regulate my hormones. I lost weight, my hair grew back, and my periods became mild. After a few years, my body "figured out" the process and I was able to go off the pill without the symptoms returning.

Jul. 13 2007 02:16 PM
Moshe from Newark

In terms of the health of birth control, we tend to think of it only as to the health of the individual woman. However, biologically speaking, if scientists were to notice that say Polar Bears, for example, stopped reproducing at replacement rates, they would be concerned. I suspect that studies would be done to evaluate environmental factors that could be contributing to the negative birth rate. In nature, negative birth rate among animals is a sign of something being wrong. Yet, among Western mankind, we don't seem to be concerned about our falling birth rate. So perhaps a good topic instead would be to discuss how to increase the per female birth rate in the West and what societal factors are causing women to not desire large families.

All across the Western world declining birth rates threaten the long term survival of Western man. Look at Europe and how its women are no longer even producing enough children to sustain themselves are replacement levels. With socilaized healthcare and pensions, this is disastrous given the larger older populations. In this country, if you exclude the birth rate of the immigrants, our native women are not producing enough children. Perhaps the discussion should be what should we do to encourage women to have more children.

Jul. 13 2007 01:44 PM
Amy from Brooklyn

I am always curious how long it is safe to be on the pill if I eventually want to have a baby. If one year reduces your risk of certain cancers, how much longer is recommended for continued pill use?

Jul. 13 2007 01:42 PM
Emily from East Brunswick, NJ

Although I know that medicine has made recent progress, I'm actually surprised that contraception is still as difficult as it is. I'm a very educated person, but haven't found a method that works for me. The various pills that I've tried have had really frustrating side effects; other methods are unappealing to my husband or myself for various reasons. The problem is compounded by a sense of never knowing how likely I actually am to get pregnant, a discomfort in talking with my friends, and the feeling that my gynecologist is rushing me out of the office, and I feel really stuck! Is anyone really happy with their method?

Jul. 13 2007 01:33 PM

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