February 24, 2012

Another Perspective To Consider in the Debate about Birth Control

As political hostilities rise in the debate about birth control and healthcare legislation, one should ask if all perspectives of this issue have been explored?

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Birth control

Birth control

For the past two months, I have been planning to blog about alternative uses for hormonal contraceptives, but have yet to follow through. In light of the current political turmoil surrounding access to hormonal contraceptives and healthcare coverage, I thought this might be good timing.

Hormonal Contraception

The hormonal contraceptive pill (i.e. birth control pill; the pill) was invented and released in 1960 to provide women with options in terms of family planning and preventing pregnancy. The pill (as well as the other hormonal contraceptive methods now on the market today such as Nuva Ring and the Patch) contains synthetic hormones which mimic hormones naturally produced in women’s bodies (i.e. estrogen and progesterone). Hormonal contraceptive methods prevent pregnancy by preventing a woman from ovulating (i.e. releasing an egg each month, which, if fertilized by man’s sperm, would result in a pregnancy).

Each month a woman’s body will cycle through different levels of hormones (such as estrogen, progesterone, and others) and the changing concentrations of these hormones contributes to when a woman ovulates. After a woman ovulates, if the egg is not fertilized, she will have her menstrual cycle (i.e. period). However, the synthetic hormones in hormonal contraceptives essentially take over this process, preventing the release of the egg each month. Women on most hormonal contraceptive methods still have menstrual cycles, but their likelihood of getting pregnant is significantly diminished because the pill is intended to prevent ovulation.

Why do women use hormonal contraception?

Pregnancy prevention and family planning are the main reasons women utilize hormonal contraception. But there are many other reasons women may seek out hormonal contraception. For example, hormonal contraceptives are effective in treating the symptoms of endometriosis. Women who suffer from endometriosis may experience pain during ovulation. For some women, ovulation can be extremely painful to the point of being debilitating. Preventing women from ovulating would be a useful mechanism to elevate this pain. As such, women have utilized hormonal contraception to prevent ovulation so that they do not have to suffer each month.

Women have also reported utilizing hormonal contraception to control the timing of their monthly cycle. Women may want control of when they will menstruate each month for a number of reasons. In fact, Stephanie Hinton and colleagues from Indiana University, Department of Kinesiology found that collegiate competitive swimmers have utilized hormonal contraception to control the timing of their menstrual cycle likely for the purposes of avoiding their period during competition. They report that alternative uses of hormonal contraception have been under explored and warrant further research. However, it is clear that women utilize hormonal contraception for purposes other than pregnancy prevention.

The Debate Over Hormonal Contraception Healthcare Coverage

I think an important contribution to make to the current debates surrounding access and healthcare coverage of hormonal contraception is that hormonal contraceptives are used for many other purposes beside and/or in addition to pregnancy prevention. In some cases, these reasons include medical treatment for disease. The debates over contraception coverage has been covered in the mainstream media as a separation of church and state issue. For those not familiar with the issue, new healthcare legislation from the Obama administration wanted to require places of employment to provide financial coverage for hormonal contraceptive methods. In response, the Catholic Church was quite vocal in expressing their discontent with this aspect of the legislation. They maintain that there should be a separation of church and state and that requiring places of employment (including Catholic employers like University of Norte Dame or catholic hospitals) to provide coverage goes against their religious beliefs. For more information on this issue, see Burke Denning’s blog: Full Coverage of Contraception Costs for Insured Employees.

I do not agree with the church versus statement argument in this case. The legislation did not aim to force anyone to utilize hormonal contraceptives; instead it was supposed to ensure that employers provided healthcare coverage for female employees who would like to utilize them. I actually think that providing financial coverage represents appropriate separation of church and state in that it allows people freedom to practice their religion and perhaps not utilize hormonal contraception, but also allows others access to this medication, if they want it or need to use it. I think this argument is further compounded by the fact that many women utilize contraception for other purposes aside from pregnancy prevention. As such, denying them access to this medication financially would be like refusing to cover medication for someone who suffers from a chronic illness like diabetes. During this debate about religion and rights, I am wondering if anyone has stopped to consider that hormonal contraception is a medication and has been and can be used in a variety of ways outside of pregnancy prevention. I think this fact has been left out of the debates going on in the mainstream media and is something that both sides should consider a bit more.