Since the 1960s American woman have had the choice to use oral contraceptives as a way to prevent pregnancy. The oral contraceptives of yesteryear contained high amounts of hormones that were not as safe for woman. Today, oral contraceptives have become safer for women to take for extended periods of time. Not to mention that oral contraceptives have become common place in our society. In todays busy world women have chosen to take oral contraceptives not only as prevention against pregnancy, but as a way to control their menstrual cycle. For centuries women have been burdened with monthly headaches, bloating, cramping, and extreme fatigue associated with their menstrual cycle. With the creation of the birth control pill, also called an oral contraceptive, women have been given the chance to decrease, or even totally eradicate monthly symptoms associated with their menstrual cycles. But at what cost are woman willing to go in order to have less symptomatic periods?
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To understand better how oral contraceptives affect a womans body and wellness this paper will demonstrate how three different types of oral contraceptives work. This paper will also discuss the history of oral contraceptives including its many uses over the years including how early oral contraceptives were strictly used for the prevention of pregnancy. This paper will also discuss when women started using oral contraceptive as a means to control symptoms of their menstrual cycles, not just prevent pregnancy. This paper will then discuss the shift from oral contraceptives preventing pregnancy, and easing menstrual pain has transferred to a measure of suppressing ones menstrual cycle all together. With the new use of suppressing a womans menstrual cycle, advertisers of continuous-use oral contraceptives are conditioning women to have a negative image of menstruation which is leading women to suppress their periods.
In order to better understand how oral contraceptives effect a womans body one must understand the types of pills that are available to the American public. The most common type of oral contraceptive is the combination pill. The combination pill releases both estragon and progesterone for 21 days, followed by 7 days of sugar, or placebo pills. The combination pill prevents a womans body from releasing an egg during ovulation, as well as creating a thick mucus in the uterine lining that makes it almost impossible for a sperm to reach an egg. This mucus lining will also makes it almost impossible for a fertilized egg to implant itself into a womans uterus.(Mamo and Fosket 2009:937) Women will still have a menstrual cycle while on the combination oral contraceptive.
The second type of oral contraceptive is the progesterone-only pill, or the mini pill. The mini pill must be taken every day because there are no placebo pills. This oral contraceptive works by making cervical mucus so thick that the sperm will not be able to reach the egg. This form of oral contraceptive is also safe to use while breastfeeding because of the lower level of hormones. In a combination pill a breastfeeding woman can risk her milk drying up because of the high estrogen level in the pill. There are newer brands of this progesterone-only pill that can stop ovulation; however they are not available for use in America. (Population reports 2005)
The third and newest addition to the oral contraceptive family is the continuous-use oral contraceptives. This form of oral contraceptive is taken continuously for three months with no placebo pills. The constant intake of hormones allows the user to essentially skip three menstrual cycles all together, letting a woman have only 4 menstrual cycles a year.(Mamo and Fosket 2009:927) The continuous-use contraceptive is relatively new to the American market, however the concept of taking an oral contraceptive to skip, or eliminate a menstrual cycle is not a new idea. Since the nineteen sixties doctors have been manipulating oral contraceptives in order to help a patient skip her menstrual cycle so it will not interfere with important events such as honeymoons, vacations, business trips, and sporting events. (Nelson 2007:464)
The FDA approved the use of oral contraceptives in the early nineteen-sixties. Since their introduction they have been commonly used by American woman as a way to prevent pregnancy. (Nealson 2007:464) When the pill first arrived in America the hormone level was much higher and caused problems, including sever depression and nausea, among women who used them. Later a new formulation was created that allowed for the same pregnancy prevention measures with fewer side effects. This new pill gave woman the ability to choose when to have a child or when to not have a child. (Mamo and Fosket 2009:928) Researchers assumed that it would take woman a while to warm up to the idea of an artificial hormone that was taken orally as a way to prevent a pregnancy. Doctors and researchers thought that Women might experience too much anxiety about the possibility of pregnancy (Andrist et al. 2004:31). However it has been almost five decades since the introduction of oral contraceptives and woman all across America have chosen oral contraceptives as their primary form of birth control.
There was a switch in the use for oral contraceptives over the years. Something that was once used by women to prevent an unwanted pregnancy is now being used by women to treat monthly menstrual symptoms. These symptoms can range from mild to severe, and can be present from days to weeks. The symptoms include, but are not limited to, abdominal cramping, bloating, headaches, fatigue, acne, general irritability, and mood swings.(population reports 2005) These menstrual symptoms, although irritating and generally uncomfortable are not life threatening. There are certain conditions that are more severe and can be a health risk. Oral contraceptives can be used to treat these severe menstrual symptoms such as dysmenorrheal also know as sever menstrual cramping, menorrhagia which is heavy bleeding that can lead to anemia.(Nelson. 2007: 464) Oral contraceptives can also treat disorders such as uterine fibroids and endometriosis which cause extreme pain and can often lead to painful and expensive surgeries. (Andrist et al. 2004: 32) Anita Nelson (2007) found that even though oral contraceptives may help treat certain medical conditions and menstrual symptoms they offer no documented health benefits.
It was not until recently that oral contraceptives have taken on yet another purpose. Gone are the days of oral contraceptives used to prevent pregnancy, or to lighten your menstrual related symptoms. Now oral contraceptives are being used to limit the number of menstrual cycles a woman has a year, or even totally eliminate a womans menstrual cycle altogether. In 2003 the FDA approved the continuous-use oral contraceptive. (Mamo and Fosket 2009:925) The most commonly used continuous-use oral contraceptive is Seasonal or Seasonique.
The benefits of the continuous-use oral contraceptives are very similar to combination, and progesterone-only oral contraceptives. With less menstrual cycles comes less menstrual symptoms. There are also certain groups of woman that seem to benefit from not having a monthly menstrual cycle. Female members of the military may benefit from not having a monthly menstrual cycle mainly when on active duty, or when stationed in another country where facilities may not be as convenient. Another group of woman that can benefit from taking a continuous-use oral contraceptive is mentally handicapped woman who may not fully understand how to take care of themselves hygienically. (Andrist et al. 2004: 32)
A recent study came to the conclusion that only 33 percent of women would be willing to suppress their menstrual cycles. When told that there would be no negative side effects that number jumped to 68 percent. (Rose et al. 2008:693) There are however some negative aspects associated with taking the continuous-use oral contraceptive. The main drawback with taking a continuous-use oral contraceptive is that many women will experience what is called breakthrough bleeding. Breakthrough bleeding occurs indiscriminately and has no specific duration. (Nelson 2007: 465) For women taking this oral contraceptive to stop menstruation, breakthrough bleeding is a major drawback. At least when a woman has a regular menstrual cycle she has an idea of the day that her menstruation will start, and therefore be prepared.
Many arguments for the continuous-use oral contraceptive say that a woman does not have a physical necessity for a monthly menstrual cycle when on the pill, which may sound like a welcome change. When Consumer reports (2008) did a survey of 375 obstetricians and gynecologist they all agreed that it is completely safe for a woman to suppress her menstrual cycle. These doctors have also recommended Seasonal or Seasonique to their patients. However there is virtually no long term research on the effects that the continuous-use oral contraceptive has on mental, physical, and fertility health when used long-term. (Andrist et al. 2004: 36)
When a woman is on a combination oral contraceptive, or a progesterone only oral contraceptive she will still have a monthly period. When I woman is on a continuous-use oral contraceptive she will not have a menstrual cycle for over three month. When asked, over 80 percent of woman surveyed said that having a monthly menstrual cycle assured them that they were not pregnant; however they would still be willing to go on a continuous-use oral contraceptive which would suppress their period for extended lengths of time. (Andrist et al. 2004: 35) These percents would suggest that women an overwhelming majority of women would be willing to take an oral contraceptive that would suppress their period. In another study 89 percent of women have heard of menstrual suppressants, a majority of these women believed that menstrual suppression is taking a pain killer such as Tylenol or Naproxen to suppress the pain. (Rose et al. 2008:698) This brings up the argument that women who are willing to suppress their periods may not fully understand what the term means. Advertisers may be taking advantage of women who have a negative attitude of their period, and may not fully understand what menstrual suppression means for them.
Mamo and Fosket (2009) argue that the continuous-use oral contraceptive is conditioning women to think about their menstrual cycles in a negative fashion. Women are being told by advertisers of continuous-use oral contraceptives, such as Seasonal, are sending out the message that menstruation is both irritating and unnecessary. Seasonique and Seasonal advertisers are treating menstruation as though it is an illness that can be treated with medication. There was a questionnaire created in the 1960s. This questionnaire was created by Moos and was called the Menstrual Distress Questionnaire. The questions on this survey discuss only the negative sides of a womans menstrual cycle. The five main attitudes mentioned in the survey are, Menstruation as a debilitating event, menstruation as a bothersome event, anticipation and prediction of menstruation, denial of the effects of menstruation, and menstruation as a natural event (Rose et al. 2007: 690) Of the above questionnaire only one aspect depicts menstruation as a natural process, or as a positive process. This is unfair for women who are taking this survey because even though a womans menstrual cycle may be bothersome; it is by far 100 percent natural. If it were not biologically necessary, not every normal healthy woman would have one.
An old argument for menstrual suppression states that women is other parts of the world menstruate a quarter of what American women do. True these women may have less menstrual cycles them women in the United States, but, they are pregnant for a majority of their adult lives. Not to mention that when they are not pregnant they are breastfeeding, and breastfeeding on average two years longer then American women. When a women breastfeeds she may actually stop ovulating. When a woman does not ovulate, she does not have a period. (Andrist et al. 2004) So the reason that women in other countries have less periods then American women has nothing to do with them biologically requiring fewer periods. It has to do with the fact that they are not ovulating due to pregnancy and breastfeeding.
With so many reasons to ovulate and have a menstrual cycle women are still reluctant to say they see the positive sides in menstruation. When women menstruates it is a way of her body telling her that she is young, has a healthy body, and is able to procreate should she choose to do so. If we can help women understand that menstruation is a naturally occurring function of the body that is a way of letting her know she is healthy, women would be less likely to want to suppress their menstrual cycle. (Rose et al. 2008) With fewer women taking oral contraceptives there might be a chance of reducing the number of side-effect related illnesses or accidents due to oral contraceptives.
Creators of continuous-use oral contraceptives use America womens culturally created dislike for their periods as leverage to sell their product. Laura Mamo and Jennifer Ruth Fosket (2009) observed that,
The message about menstruation in the advertising campaigns attempts to reshape the very way in which we thing about menstruation, constructing
it as an unnaturally frequent event that can safely and easily be lessened or
even avoided altogether. When translated into action, these messages then
transform embodiment by limiting menstruation, among other biological
changes that result from daily ingestion of drugs, and be transforming
knowledge about bodies themselves.
This kind of negative advertising can be observed in a recent Seasonal commercial where the women in the commercial is wearing all white and hoping all over the screen as if she has been freed from her innate illness, in this case her menstrual cycle.(Consumer Reports 2008) When women are subject to this kind of advertisement they start to believe that by limiting your menstrual cycle or eliminating it all together she too can embrace her true femininity.(Rose et al. 2008) But at what cost is she willing to go to embrace her said femininity. As stated before there is little to no long term studies on the effects of long term menstrual suppression, and long term effects with regular oral contraceptives can range from ovarian cancer, to deep vein thrombosis.(Roell et al. 2007:165)
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I did a small interview with Michele Berkes-Adams, a yoga and palates instructor, as well as massage therapist and certified reflexologist. She has taught yoga classes that help women focus on their moon cycle or menstrual cycle as well as ovulation. She said that, Eating a healthy balanced diet, resting when possible, and having a regular exercise routine can help most women deal with menstrual troubles. If these and Advil dont help, then see a doctor and educate yourself on possible options. She then went on to talk about how women today do not want the magic pill that will help them, and will take that pill at any cost to their health. She also discussed how there are other forms of birth control that when used properly can not only prevent pregnancy, but help reduce the spread of sexually-transmitted diseases, something oral contraceptives does not do.
In a study done by The Journal of the American Academy of Nurse Practitioners (Andrist et al. 2004 35) 63 percent of woman would choose to go on an oral contraceptive in order to reduce menstrual pain. However, there are natural ways to help relieve the symptoms related to a womans menstrual cycle that do not include hormones and have no negative side effects. Woman can choose to do yoga around the time of menstruation. Certain asanas (poses) such as forward bends, cat-cow, and gentle twists can help alleviate pain in the lower back as well as cramping.(Sparrow 2005) Woman can also choose to try reflexology to help relieve symptoms of their menstrual cycle, as well as PMS symptoms. Reflexology is a gentle therapy that involves pressure point on both the hands and the feet being manipulated in order to help a patient deal with stress, anxiety, as well as pain. (Kunz. 2007: 236) There are also the old treatments that have been around just as long as oral contraceptives such as warm baths, heating pads, and pain relievers such as Tylenol or Advil to help treat certain symptoms.
When it comes to women every one is different. Some women have negative attitudes about menstruation. While other women embrace what is naturally theirs. Since the 1960s women have had to right to choose oral contraceptives as a form of birth control. Oral contraceptives have not only helped women prevent unwanted pregnancy, but it has also helped treat menstrual related symptoms that some women find annoying. However, there is a new oral contraceptive in town that not only prevents pregnancy and treat menstrual symptoms, but suppress menstruation for three months. Even though there is little to no research on the long-term effects that this form of oral contraceptive may have on a woman, it is being marketed as a safe alternative to having a period every month. The markets for these pills are conditioning women to believe that menstruation is an illness that can be treated with a medication. These drugs are taking away from what is biologically natural for a woman to do making menstruation obsolete. Women need to educate themselves on the different forms of birth control, including oral contraceptives, and always talk to a doctor before making the decision to suppress menstruation. There are always other options such as yoga, reflexology, healthy eating, and old fashion heating pads to help treat symptoms. Women also need to remember that menstruation is their bodys way of telling them they are perfectly healthy, not sick.
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