Oral contraceptives and their effect on women in the modern society

Dorotea vraka
Academic Writing 1
March 9, 2014



1

Introduction
During the early years of the 20
th
century, scientists were working on isolating and
determining the formulas of synthetic hormones. They discovered that in large doses, those
hormones inhibit ovulation. In their article, Biochemical Effects of Oral Contraceptives
Among Users: A Review, Naz et al. have summarized the data on first contraceptives. The
first synthetic compounds used as oral contraceptives were first tested on women in the
United States, Puerto Rico and Haiti. The first contraceptive pills were called Enovoid. Even
though not everyone was familiar with contraceptives back then, they are used by millions of
women all over the world today.
There are many different kinds of contraceptives today and they all have similar
effects. imuni (2013, 207), in his article Je li opravdan ponovni strah od hormonske
kontracepcije?, enumerates different kinds or hormonal contraception, which include
combined oral contraception, progesterone pills, long-term contraception, vaginal rings and
intrauterine devices which release levonorgestrel. Around 120 million women use
contraception worldwide. Despite many possible side effects, which include but are not
limited to venous thromboembolism, high blood pressure, pain in the abdomen and lower
back and mood swings (Philipson, Wakefield, and Kasparian 2011, 636), more and more
women choose oral contraceptives. For most women, their secondary effects are more
important than their basic purpose. Some of the secondary effects include shorter and less
painful periods, prevention of anemia and improving skin conditions (mainly acne) (imuni
2013, 208). According to Kissling, there are contraceptive pills in the United States which
limit the number of menstruations from the normal twelve per year to only four, which then
occur three months apart. Such pills are an excellent example of using contraceptives for
purposes other than birth control.
2

In this paper I would like to point out that the broad availability of multi-purpose
female contraceptives has changed the image of women in todays society. I aim to explain
how that occurred and how significant the impact of pharmaceutical companies and the
marketing industry was.

Understanding the properties of oral contraceptives
Combination oral contraceptives are the most widely used oral contraceptives, which
prevent pregnancy mainly by suppressing ovulation. Both progestogen and estrogen
components suppress luteinizing hormone secretion, which prevents ovulation. In addition
progestogen thickens cervical mucus so that sperm cannot penetrate the uterus and produces
endometrium that is unreceptive to ovum implantation. (Naz et al. 2012, 315)
The study that was carried out by Philipson, Wakefield, and Kasparian (2011, 636)
relied on thirteen other studies that dealt with how much women know about birth control
pills. It showed that even though physicians were advised to familiarize women with all
aspects of contraceptive use, women know very little about oral contraceptives and many of
them do not know how to use them properly. Many women are not aware of all the positive
health effects they can have, but are also not familiar with their negative side effects. I had the
opportunity to talk to four women who use oral contraceptives, aged between 20 and 28.
Three of them received no information on the possible side effects, and the same three women
asked for prescriptions of their own accord, because they have heard of their health benefits
(and secondary effects) either from other women who use them, or have read about them on
Internet health forums. Such practices are not common only in Croatia, but also occur, as
stated in the study, in the United States, so I believe that they are probably widespread across
3

the world. It is important to understand that almost every woman knows about the existence
of oral contraceptives, but few know enough about their health effects.
Philipson, Wakefield, and Kasparian (2011, 639) include women who do not use
contraceptives in their study, as well. The data shows that many women still believe that the
use of oral contraceptives is unnatural or unhealthy and frequently state that as a reason for
ceasing to use contraceptives or not using them at all in the first place. The authors say that
those beliefs are contrary to medical research supporting the general safety of oral
contraceptives and that they demonstrate the powerful subjective perceptions that motivate
individuals health behaviors. They also notice that the level of education also has to do with
the amount of information women hold on oral contraceptives, which proves unequal access
to information between those with and those without a university education.
Based on my own experience and their study, I conclude that doctors, either
physicians or gynecologists, inadequately inform their patients about the effects of oral
contraceptives. Due to that, many television, Internet and magazine commercials and hearsay
information received from other women who have already used some sort of contraceptives
profoundly affect womens knowledge about their positive or negative side-effects. Even
though Croatia does not allow marketing prescription drugs, that has been allowed in the
United States since 1997 (Kissling 2013, 494). Because of that, contraceptives are also
advertised on television, which has led to more and more patients asking their doctors for
prescriptions, mostly because of their secondary effects.

Lifestyle drugs
All data presented in this part applies to the United States drug market because it is
one of the more controversial markets and because there is plenty information available on the
4

subject. I will mostly focus on Elizabeth A. Kisslings findings from her study Pills, Periods,
and Postfeminism: The new politics of marketing birth control. The author defines the terms
lifestyle drugs as pharmaceuticals taken not to relieve or cure a medical condition, but to
improve ones quality of life (2013, 494). They are among the most heavily advertised
pharmaceutical products and the market for lifestyle drugs is currently estimated at $23 billion
and growing. Contraceptives are the first known lifestyle drug.
Kissling (2013, 490) opens her article with a very strong statement, saying that since
the English translation of Elsimar Coutinhos book Is Menstruation Obsolete? in 1999 and the
introduction of cycle-stopping birth control pills in 2003, US women have increasingly been
advised that menstruation is not necessary for good health. That prompted the creation of
Seasonique and Lybrel contraceptive pills, which are similar to all other birth control pills,
with the difference in the number of days that the pill is taken. Contraceptive pills are usually
taken during 28 days. Each pack contains 21 pills with active ingredients and 7 placebo pills.
Seasonique is taken during 91 days and contains 84 active ingredient and 7 lower-dose active
ingredient pills. If taken regularly, Seasonique reduces the total number of periods from the
usual twelve per year to a mere four, which then occur every three months. According to the
data, the pill sells very well, with the annual sales of $110 million.
The advocates of cycle-reducing pills often say that regular menstrual cycles are not
natural (Kissling, 2013, 497). Their arguments are based on comparing the menstrual cycles
of Paleolithic women and women today. From the onset of ovulation, they were constantly
pregnant, breast-feeding, or both. During pregnancy and breast-feeding they would remain
anovulatory and would therefore have been free from menstruation, not only up to the
menarche, but for most of the time until death (Kissling 2013, 497). This argument is often
used while debating drugs like Seasonique, but I find it insignificant. The usual twelve-month
menstrual cycle (if there are no disorders present) is perfectly normal in this age and the
5

hormonal oral contraceptives which aim to reduce it are unnecessary. Kissling (497) believes
that the authors who use Paleolithic arguments are highly selective of which elements of
Paleolithic life should be idealized and emulated and often forget that todays lifestyle is very
different from Paleolithic lifestyle. Women today are encouraged to shave their legs, have
their pubic hair removed with hot wax, or to deliberately starve themselves to conform to an
idealized body type. All these practices carry health risks, including menstrual cycle
disorders, which some Seasonique users list as a reason for taking those pills.
The natural function and commonness of the menstrual cycle is being questioned
due to pharmaceutical progress, and women are being taught that one of the things that has
been unique to them from the beginning of human life on Earth is useless in the modern age.
In the countries with a developed pharmaceutical industry, women are bombarded with
carefully chosen information from unreliable sources about the usefulness of different drugs.
Due to virtually nonexistent doctors advice, women accept various claims without actually
knowing how good or bad certain drugs are for them, and if they really need them.

Postfeminism, neoliberalism and birth control
Since this essay focuses on a female issue, I would like to include feminist views and
opinions about birth control. But, as Kissling states (2013, 491), in this capitalistic and
neoliberal era, feminism has in a way been lost in postfeminism. Postfeminism is an active
process by which feminist gains of the 1970s and 80s come to be undermined while appearing
to engage feminism, especially through tropes of freedom and choice (491). Feminism puts
forward a complex political identity and strategies for social change, while postfeminism
changes it according to neoliberal values that put classic liberal values such as human rights,
equality and liberty behind contract, marketplace and the individual (491).
6

Feminism puts womens non-physical qualities first and does not portray women as
sexual objects, but postfeminism allows women to present themselves as such if they want
to. Kissling (2013, 492) states that caring about ones appearance is very important in
postfeminism; women ask for expert advice to change their inadequate lives, which usually
occurs through increase or change in their consumer behaviors, because consumerism makes
up a large part of postfeminism. The increase in consumer behavior is provoked by many
advertisements which promote a right or a desirable lifestyle. The commercials label the
female body as an object which requires constant caretaking. Many lifestyle drugs,
particularly contraceptives, are advertised as well. Kissling ((2013, 495) says that birth control
commercials can be seen regularly on most American television channels. During my stay in
the United States in 2008 and 2009, I have indeed seen many such commercials. Those mostly
advertise pills which cannot be bought without a prescription.
The desirable female body which such commercials portray is the body which does
not menstruate, or does so in a controlled manner. Periods are spontaneous, sometimes even
unpredictable, and with them carry symptoms such as bloating and emotional instability
which could damage ones self-presentation as a rational subject who keeps everything under
control, also the ideal neoliberal subject (Kissling 2013, 500). Todays jobs require constant
adjustment to a new working environment and the responsibility for discipline and respect of
that environment falls to the individual. Contraceptives which stop or decrease the number of
yearly periods are just one of the ways to discipline an individual. Contraceptive commercials
mostly emphasize their secondary effects, while the primary effect, contraception itself, is
vaguely mentioned. It is emphasized that reducing the number of periods will change
womens lives and so contraceptives become a part of the postfeminist paradigm.
That is how contraceptives, along with other pharmaceuticals and make-up, and
backed by the marketing industry, have changed the image of women in the modern society.
7

They have once again undermined feminist values which are being propagated as the alleged
postfeminist guidelines. The basic functions of birth control contraception is suppressed
before numerous other effects which help in creating the ideal woman, that is the ideal worker
in the capitalist, neoliberal society.
















8

References


Kissling, Elizabeth. 2013. PILLS, PERIODS, AND POSTFEMINISM: The new
politics of marketing birth control. Feminist Media Studies. 13 (3): 490-504.

Naz, Falaq, S. Jyoti, M. Afzal, Y.H. Siddique. 2012. Biochemical Effects of Oral
Contraceptives among Users: A Review. International Journal of Pharmacology. 8.: 314-20.

Philipson, Sarah, C. Wakefield, N. Kasparian. 2011. Womens Knowledge, Beliefs,
and Information Needs in Relation to the Risks and Benefits Associated with Use of the Oral
Contraceptive Pill. Journal of Women's Health. 20 (4): 635-42.

imuni, Velimir. 2013. Je li opravdan ponovni strah od hormonske kontracepcije?.
Medix. 104/105: 207-15.










9