In recent years, there has been great debate about access to contraception, particularly the hormonal birth control pill. In 1957, the first hormonal birth control pill was approved by the FDA for severe menstrual disorders, in 1960 it was approved for contraceptive use, and by 1965 it had been legalized for married couples by the Supreme Court. It wasn’t until 1972 when the Pill was approved for adult women regardless of marital status.
Today, access and affordability continue to be up for debate despite the progress made in the 1960s, 1970s, and 1980s. While much of the feminist movement has focused on maintaining women’s reproductive rights — a struggle marked by both hard-fought wins and troubling losses — feminist scholars, physicians, and commentators have often failed to critically assess the products that exist at the center of the debate. If a woman has access to the Pill, should she necessarily use it? What about safety, long-term side effects, and the loss of a natural reproductive cycle? What happens to our bodies and ourselves when our hormones are regulated? What are women missing out on by not experiencing their natural cycle?
Four out of every five sexually experienced women have used the Pill, and while this is just one form of hormonal birth control, many others exist, including the Mirena IUD, the Patch, the Implant, and injectable types. In 2009, reliance on long-acting reversible contraceptives (LARC, aka the IUD) rose to 8.5% of women from 2.4% of women in 2002; of these, the Mirena IUD is the most popular. For American women, it appears to be the norm to use hormonal contraceptives, as opposed to barrier methods or non-hormonal long acting reversible contraception (LARCs). With their effectiveness and seemingly noninvasive nature, it isn’t very surprising that so many use hormonal contraception.
Despite its appeal, hormonal contraception is not entirely benign. There are many side effects to taking synthetic hormones, both for the Earth (though not the largest contributor of synthetic hormones being dumped into the environment) and for women’s bodies. The negative side effects of birth control vary by age and previous health conditions. There is little research on the long-term effects of hormonal contraceptives, largely because hormone regulation affects many parts of the body in often seemingly unrelated ways 1. The list of mild common side effects includes nausea, headaches, weight gain, decreased libido, mood changes, and irregular bleeding. The more extreme are blood clots, seizures, heart conditions, abdominal pain, and blurred vision.
Moreover, hormonal contraception is a source of profit for many drug companies. The pharmaceutical industry is big business; within the United States, consumers spend more than $400 billion per year on prescription drugs, and this number keeps growing.2 The money spent on pharmaceutical advertisements was estimated to be $47 million in 1990 and increased to more than $2.5 billion by the millennium.3 This leap is largely due to the 1997 FDA decision to allow pharmaceutical advertisements on television as long as some guidelines were followed. Direct-to-consumer advertisements often introduce information about a pharmaceutical drug before patients are able to discuss them with their doctors.
While originally intended to prevent pregnancy, advertisements for hormonal birth control, especially the Pill, have increasingly targeted the cessation of menstruation and all of the “hassle” that comes with it. The popular rhetoric in hormonal birth control advertisements, women’s magazines, websites, and blogs is that menstruation is not necessary for good health. Menstrual suppression has become the norm for hormonal birth control and has, over time, turned into a strong selling point. By portraying this suppression as logical, many advertisements “problematize women’s natural bodies and reflect a trend to increasingly rely on technology/medicine to ‘alter’ women’s natural menses.”4 As is common with pharmaceutical advertisements, the ads run quickly through the possible side effects with smiling faces in video, and in tiny black and white print in magazines. When the seriousness of these side effects is cursorily dismissed, consumers might think: nothing bad happened to the women in the ads, why would it happen to me?
The Pill can now cure all types of feminine “symptoms,” such as bloating, irritability, premenstrual dysphoric disorder, premenstrual syndrome, acne, menstruation, menstrual pain, and anxiety. One advertisement in particular shows women punching these “symptoms” out of the air, as if the body is the enemy, something pills can help us fight against. Symptomizing women’s natural bodily functions creates a bigger market for pharmaceutical companies and little room for alternative, such as holistic, viewpoints.
Essentially, the industry has rebranded common female experiences with the distinction of a “disorder.” Even among women who do suffer from the ailments described above, hormonal birth control is still problematic. As Susan Rako, author of No More Periods, points out, “without an appreciation of the complexity of hormones’ effects upon one another and of their far-reaching effects on every organ in the body, we are not equipped to understand the risks of hormonal manipulation.”5 Birth control is no longer just a matter of controlling reproduction; many women can identify with one of the many “symptoms” and find good reason to use one of many forms of hormonal birth control.
While hormonal contraception has its problems, it is hard to have nuanced conversations and critiques about things like the Pill without acknowledging the historical context. Hormonal contraceptives continue to do great things for women’s lives. The power to control conception has been a hard-earned right for women, but it shouldn’t force us to passively accept the hormonal disruption it does to our bodies. Without a critical look at the many issues surrounding it, we are settling for a product that is largely controlled by pharmaceutical companies, advertised coercively, and ultimately, may be destructive to our bodies.
- E. A. Kissling, “Pills, Periods, and Postfeminism” Feminist Media Studies, 13:3 (2012): 490-504. Return to text.
- J. Sandoval, “Controlling the Chaos? An Ecofeminist Discourse Analysis of Feminine Health Norms in Pharmaceutical Advertising” Paper presented at the National Communication Association, San Diego, CA (November 2008). Return to text.
- K. Kaphingst, W. Dejon, R. Rudd, & L. Daltroy, “A Content Analysis of Direct-to-Consumer Television Prescription Drug Advertisements” Journal of Health Communication 9 (2004): 515-528. Return to text.
- G. Bihn-Coss, “Controlling Nature: Contraception, Menstrual Suppression, and Fertility in Women’s Magazine Advertisements” Paper presented at the National Communication Association, San Diego, CA, (November 2008), 26. Return to text.
- S. Rako, No More Periods? The Risk of Menstrual Suppression and Other Cutting-edge Issues About Hormones and Women’s Health (New York: Harmony Books, 2003). Return to text.
What do you make of arguments that decades of non-pregnant cycles is not exactly “natural” either?
I have not done much research into that theory, but I do think plenty of women throughout history have not had children in their lifetimes. I am not discounting hormonal contraception entirely; I am raising concern about its widespread and longterm use. I am also concerned about the intentions behind those that create, promote, and sell the drug. I wonder what women are missing that forgo their natural cycles for most of their lives? Certainly that is no more natural than ovulating for the entirety of your reproductive life.
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