Welcome to the world of Do It Yourself Doctoring. Recent reports indicate that the birth control pill may become available in the United States without a prescription. Proponents will claim this makes women's lives healthier and easier. Nothing could be further from the truth.
The pill is not Tylenol or cough medication. Certainly it's widely used. However, forever downplayed are the nasty and known side effects: There's the risk of blood clots leading to stroke. There's mood swings. There's increased risk of cervical cancer, (alongside the highly touted effect of decreasing the risk of ovarian cancer). There's a 44-per-cent increased risk of developing breast cancer for young women prior to having children, a finding published in the Mayo Clinic journal in 2006. Anecdotal evidence has some women feeling permanently nauseous, others get depressed. Still others say they lose, wait for the irony, the desire to have sex.
The pill, to be clear, is not a condom. Dr. Tim Rowe, a British Columbia-based doctor and editor of the Journal of Obstetrics and Gynaecology Canada, calls having doctors prescribe the pill "paternalistic," comparing this to the fact that men don't have to see a doctor to get condoms. It's almost as if he wants the pill available at gas stations in coin operated dispensers next to cheap perfumes.
For his sake, let's compare and contrast: Condoms are not ingested and they don't contain synthetic hormones. They don't need to be taken at a particular time of day and won't have their use continued even when there's no sexual activity. They don't change the makeup of a man's body or alter the release of sperm. The World Health Organization did not classify condoms as a known carcinogen. (Yes, you read that right. WHO classified the pill as a carcinogen in 2005.) Virtually all men will acknowledge they'd never stand to take something as body altering as the pill. Not so with women: The late Barbara Seaman, an investigative journalist, wrote a book about treating women with hormones called The Greatest Experiment Ever Performed on Women. In it she documents how the pill came to be and at what cost.
That a doctor would so easily see the doctor-patient relationship eroded raises the question of what doctors are learning in medical school. Merely mentioning the Mayo Clinic study showing a link between the pill and breast cancer will raise eyebrows and ire. Medical schools are steeped in literature from pharmaceutical companies. Doctors seem to swap scribbling a prescription for fixing a problem. And we as patients are partially to blame by demanding easy, instant solutions. As a result, the pill today is overprescribed. Any complaint of problems with your monthly cycle -- be it a long cycle or a short one, concern over endometriosis or the lack of a period altogether -- is likely to be met with a pill prescription.
At this point, there's a secret subculture of women who ceased taking the pill. I couldn't stand the headaches, one will say; another will complain of feeling different, not like her real self. Even some pro-choice women's health advocates prefer to teach natural family planning (the symptothermal method) with the solid claim that it works with the same efficacy as oral contraceptives. The advantages are that it's not a product you purchase and it works with a woman's natural body rhythm. The disadvantages? It takes time to learn and teach, and pharmaceutical companies can't make money on it.
These voices are hushed up in part because pharmaceutical companies have long tentacles, and in part because the pill remains the darling of old-school feminists. It is the great equalizer. On it, you can have sex anytime without ever getting pregnant, just like men do -- or so we are told. The pill is the doctor, enjoying a position of status and authority like nobody's business, advertised with glossy pamphlets and expensive TV campaigns. Don't like it? You're moralistic, or, as per Dr. Rowe, paternalistic. When your teenage daughter wanders into a drug store to buy the pill, be it for acne or because she's having sex, we're supposed to shrug.
There's an electrician's bumper sticker that reads something like "Wiring is not a hobby." Neither is medicine. Then again, if doctors insist on comparing the pill to condoms, then perhaps Do It Yourself Doctoring will result in better decisions, after all.
Andrea Mrozek is the manager of research and communications at the Institute of Marriage and Family Canada (imfcanada.org).