Overprescribing the Pill

by Elise Ehrhard - March 28, 2011

Reprinted with permission.

When I was in college nearly 20 years ago, most of the young women I knew took birth control pills for medical reasons as instructed by their gynecologists. Now that I am in my 30s, I am encountering women who are only just discovering that they never really needed to be on the Pill in the first place.

The friends I got to know during late-night talks when I began college were still waiting for sex until marriage, or at least waiting until they had known someone a long time. Few were yet looking for contraception, even if the RA did welcome us to the dorm with a "goody bag" of condoms. Gynecologists prescribed them oral contraceptives for a variety of health conditions: One young woman had been having her period twice a month for a number of months. Another missed them for no apparent reason. One woman had very painful periods, and another had polycystic ovarian syndrome (PCOS).

By my senior year, I too was told by a gynecologist that I needed to be on the Pill. After I went to him with concerns about PMS symptoms, he immediately suggested oral contraceptives and handed me a bag of them to take home. I never used them: Something in me questioned how easily these pills were used to treat everything. When I received a second opinion, my new doctor said bluntly, "Prescribing the Pill for your condition is like killing a flea with an elephant gun." As it turned out, I just needed better nutrition and more B vitamins.

After a second friend of mine received a diagnosis of PCOS, her doctor told her oral contraceptives were unnecessary. This was the first time in college that I had heard of a gynecologist not prescribing the Pill for a condition.

Another friend with PCOS whom I will call "Michelle" had been prescribed the Pill since she was 16 years old. Not only was it unnecessary, but the contraceptives exacerbated more severe health problems. Having struggled for many years with debilitating depression, Michelle went to a psychiatrist who advised her to get off the Pill immediately.

When Michelle went back to her gynecologist to inform the doctor of her suicidal tendencies, her ob-gyn sighed with frustration. "How suicidal?" she asked.

That was enough for Michelle, and she stopped taking the Pill. Soon she began to feel a level of sexual desire that had been largely suppressed by the contraceptive since she started taking it at 16. With natural hormones racing through her body for the first time in years, she realized she had never had the chance to experience the normal libido that young women discover as part of their maturation process.

"My body suddenly feels like a teenage girl's again," she said. On this point there is no debate: Even proponents of the Pill acknowledge that it reduces a woman's sexual drive. Therefore, millions of women spend much of their prime reproductive years never knowing the natural level of sexual feeling that is part of developing as a woman.

"I spent my 20s on the Pill and anti-depressants," another friend recently told me. "Only after I got off the Pill and had my kids did I realize that I needed neither. I just needed dietary changes and more exercise." Now nearly 35 and expecting her third child, she is feeling better than she has felt in years. She only regrets being prescribed the contraceptive by doctors when she was so young, which kept her from discovering and treating the root causes of her health problems.

Even when a woman eventually goes off the Pill (usually in her 30s, because of the increased risk of cardiovascular problems), her underlying health issues will remain. The contraceptive does not actually "treat" anything; it simply puts potential health issues on the backburner for a decade or two. In her recent eye-opening piece for New York Magazine, "Waking Up from the Pill," Vanessa Grigoriadis captures the effect this delay has on women's lives in the long run:

Whatever "irregularities" a woman may have experienced in her teenage years before going on the Pill will likely be around when she goes off it. "Some women who come off the Pill in their thirties are surprised that it takes a few cycles to get their periods back, or that they may have very long cycles, or cycles without ovulation," says Jill Blakeway, founder of acupuncture center Yinova near Union Square and a co-author of the cult book Making Babies. "The Pill didn't create these problems: In most cases, the problems were there all the time, but because they were on the Pill, these women were never motivated to deal with them. And now they have a time issue."

Talk to college girls today, and you will find that over-prescription of oral contraceptives continues unabated.

Why is the Pill so attractive to the medical community? Theories abound. It could be that many doctors, particularly those in student health clinics, do not feel they have the time to consider the variety of factors that influence women's reproductive cycles. Or maybe an element of social engineering is at play. After all, everything from poverty to child abuse is blamed on women not taking contraceptives. Large segments of our culture push the idea that the world would be a better place if single women between the ages of 16 and 25 did not ovulate. This view is highly misogynistic, even if it is touted by groups purporting to advocate for women.

Yet many young women are still uncomfortable with the idea of using artificial hormones to avoid pregnancy. Practicing Catholic women reject the Pill for reasons of faith. For many, the idea of shutting off one's cycle feels unnatural. As Grigoriadis notes, "Removal from one's true biological processes was more appealing in the Mad Men era, when machines were going to save the world and pills could fix everything, even the ennui of housewives."

By medicalizing the Pill and telling unsure young women that they must take it for their health, our secular culture can bypass a young woman's "hang-ups" about artificial contraceptives and ensure she is on the hormones regardless of her personal beliefs.

So here is a note to young women, or any parent whose daughter will be making a trip to the gynecologist one day: The vast majority of health problems or irregularities for which the medical community prescribes the Pill can in fact be treated with alternatives such as better nutrition, stress reduction, vitamin supplementation, or natural progesterone therapy. Books such as Marilyn Shannon's Fertility, Cycles and Nutrition and The Art of Natural Family Planning by John and Sheila Kippley detail many of these solutions.

It is important to explore these alternatives before agreeing to take oral contraceptives. When it comes to dealing with doctors and taking the Pill, young women must question the gynecological community and trust in themselves.

Elise Ehrhard is a freelance writer whose work has appeared in the Chicago Tribune and the American Feminist, the national magazine of Feminists for Life of America. She currently writes a weekly column on Catholicism and culture for UPI.