Source on DocSharon's information about BC?

[VoiP]

Hello, everyone. I've lurked for about half a year. On the old site, DocSharon said this about hormonal birth control:

The info about birth control pills and other methods of contraception containing progesterone leading to thinning of the uterine lining is true. That's the information that, back in the early days of hormonal contraception, caused medical experts to speculate that this thin uterine lining might make it difficult for a fertilized egg to implant and that that might be one of the ways in which they prevent pregnancy. That information has since been pretty well debunked.

For example, women who conceive while taking the pill should have a higher rate of miscarriage than women who conceive while not on hormonal contraception. They don't. There's also the fact that women at risk for early miscarriage who are treated with progesterone are less likely to miscarry again.

Also, if a woman has enough ovarian function to ovulate while on the pill, her ovary will contain a corpus luteum which produces enough progesterone to maintain normal pregnancy until the placenta develops and takes over. So, even if she's on the pill, if she's pregnant, she's got normal amounts of pregnancy hormones coming from the usual places which should override the pill's effects.In other words, it was a theory that is now essentially disproven.

Alas, the FDA has very strict rule about labelling and getting them to remove it would cost a fortune and, since the pill manufacturers don't see a lot of people refusing to use their products because if it, they're not going to invest the millions needed to do the study and present the case.

Many people also think the 'morning after' pill causes abortions, it does not. Once again, there's that theoretical risk because a woman who takes it will have bleeding a few days later due to withdrawal. Some take this to mean she will be 'washing out' a fertilized egg. The only problem is that the fertilized egg doesn't even get to the uterus for a week. Anytime a woman is exposed to a high dose of estrogen or progesterone, whether from contraception, menopausal replacement hormones, or even natural ovulation; she will bleed when those hormones are gone.

But, here's the thing: we do not conceive immediately after having sex, sperm are tiny and they've got a long way to go to get to the egg. We know from infertility research that a woman is most likely to conceive if she has sex a couple of days before she ovulates. Why? Because sperm can live about 3 days in a woman's reproductive tract while the egg is only viable for about 18 hours. It takes the 'average' sperm 3 days to get to the egg and fertilize it, which happens in the fallopian tubes, BTW. Therefore, if a woman waits until she's already ovulated to have sex, her egg is probably going to be non-viable by the time the sperm gets to it 3 days later.

Therefore, a morning after pill works by delaying ovulation in a woman who has had unprotected intercourse as long as she takes it before she ovulates. It causes her ovary to hold onto the egg for a couple of days longer, so that the sperm will be gone by the time it gets to the tube and which also probably causes the egg to be not as easily fertilized as it has 'cooked too long' so to speak.

There is also an empiric reason why we know that the 'morning after' pill doesn't prevent implantation. Aside from the fact that women get pregnant even after taking it, the pregnancy rate for the morning after pill is higher than the pregnancy rate for the regular pill. If the withdrawal bleeding caused by the morning after pill was so effective at preventing implantation, it should have a lower pregnancy rate that the regular pill or at least be as good. It isn't.

I found this very interesting, and I brought it up yesterday in a conversation with my sister, who thinks hormonal birth control is an abortifacient. She asked me to provide a reference. Does DocSharon post on the new site? Do any of you have links to medical articles or textbooks that I can use? Thank you very much.

[starfish]

'Cuz DocSharon said so and she's the bomb.

[gustava]

'Cuz DocSharon said so and she's the bomb.

Chime +

[SunnyAndrsn]

Medical school, I assume. There are several MD's over here now, hopefully they can chime in and provide a specific source

[VoiP]

Medical school, I assume. There are several MD's over here now, hopefully they can chime in and provide a specific source

See, I'm worried that someone who already believes birth control is an abortifacient won't believe me when I say "LOL SOME DOCTOR TOLD ME BUT NO HARDCOPY GUYS."

[twin2]

See, I'm worried that someone who already believes birth control is an abortifacient won't believe me when I say "LOL SOME DOCTOR TOLD ME BUT NO HARDCOPY GUYS."

I pulled out this review from a quick pubmed search

Am J Obstet Gynecol. 1999 Nov;181(5 Pt 1):1263-9.

The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices.

Rivera R, Yacobson I, Grimes D.

Source

Family Health International, Research Triangle Park, NC 27709, USA.

Abstract

Modern hormonal contraceptives and intrauterine contraceptive devices have multiple biologic effects. Some of them may be the primary mechanism of contraceptive action, whereas others are secondary. For combined oral contraceptives and progestin-only methods, the main mechanisms are ovulation inhibition and changes in the cervical mucus that inhibit sperm penetration. The hormonal methods, particularly the low-dose progestin-only products and emergency contraceptive pills, have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence indicates that prevention of implantation actually results from the use of these methods. Once pregnancy begins, none of these methods has an abortifacient action. The precise mechanism of intrauterine contraceptive devices is unclear. Current evidence indicates they exert their primary effect before fertilization, reducing the opportunity of sperm to fertilize an ovum.

The mechanism of action of contraceptive method is essential for the development of new methods. It also influences cultural and individual acceptability of a contraceptive method. Modern hormonal contraceptives and intrauterine contraceptive devices have multiple biologic effects. Some of them may be the primary mechanism of contraceptive action, whereas others are secondary. For the combined oral contraceptives and progestin-only methods, the main mechanism of action are the inhibition of follicular development, ovulation, and as consequence, corpus luteum formation. Further, it is also involved in the alteration of the cervical mucus that inhibit sperm penetration. For hormonal methods, particularly the low-dose progestin-only products and emergency contraceptive pills have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence will indicate that prevention of implantation actually results from the use of these methods. Once implantation has taken place, none of these methods are effective and pregnancy proceeds normally. The precise mechanism of IUDs remains unclear because of difficulties in carrying out relevant investigations in humans and the limitations of extrapolating findings from animal studies. However, several studies evidenced that IUDs exert their primary effect before fertilization, by impeding the ascent of sperm to the fallopian tubes or by reducing the ability of sperm to fertilize an ovum.

I don't have access to the full length article at this time, but I can get a the full article at work tomorrow and send it to you if you like. This is a review article, but it is a good way to start as it will cite the original studies.

[VoiP]

The hormonal methods, particularly the low-dose progestin-only products and emergency contraceptive pills, have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence indicates that prevention of implantation actually results from the use of these methods.

My sister referred to that study, quoted that very sentence (only that sentence), and then said:

It's from 1999, so the scientific evidence they were looking for may have turned up in the past 12 years.

Sigh.

[twin2]

My sister quoted that study, quoted that very sentence, and then said:

:doh:

Often times, when it comes down to issues like this, people are going to believe whatever that want to believe. You could probably hit your sister over the head with every paper published in the mechanism of action of oral contraceptives and she won't change her mind.

[browngrl]

Hi,

I'm not an ob-gyne but I am a doctor. My information is gleaned the ob-gynes I work with. Most of the doctors I work with are women and so am I so I don't know how valid fundamentalists would consider my opinion since it does come from a woman. None the less....

Emergency contraception does not have an effect on an established pregnancy ie if a woman is already pregnant emergency contraception will not act as an "abortion pill". The exact method of action of emergency contraception is not definitively established (as far as I am aware). It most likely acts by interfering with ovulation (eg by delaying it or preventing it or making ovulation dysfunctional). If the woman is pregnant then there are no studies (that I am aware of) that oral contraceptives cause teratogenicity (ie malformations).

My personal opinion: emergency contraception is a very useful tool. It does not cause abortion. However I think that all women should think carefully about their contraception needs or beliefs before the issue comes up and all women need to be aware of and take precautions against sexually transmitted diseases. I think that if fundamentalists want to prevent pregnancy and disease by abstinence that is fine for them, but they SHOULD NOT interfere with the right of other women to have a choice. It is greatly important (in my opinion) that women retain control and choice over their bodies.

[Witsec1]

Thanks for the info about emergency contraception, browngrl, I didn't know exactly how that worked. I think what VoIP is referring to is the belief, popularized by the Duggars, among others, that the regular non-emergency pill will cause abortions.

[VoiP]

Thanks for the info about emergency contraception, browngrl, I didn't know exactly how that worked. I think what VoIP is referring to is the belief, popularized by the Duggars, among others, that the regular non-emergency pill will cause abortions.

Yes.

[masagoroll]

My sister referred to that study, quoted that very sentence (only that sentence), and then said:

Sigh.

Is that an angry sperm swimming away in disgust?? We have some strange smilies here!

[VoiP]

Is that an angry sperm swimming away in disgust?? We have some strange smilies here!

I prefer to think of the sperm as depressed and frustrated. After all, I don't hate my sister, I'm not even mad at her, really. I'm willing to respect the way she lives if she extends the same thought to me.

[browngrl]

Thanks for the info about emergency contraception, browngrl, I didn't know exactly how that worked. I think what VoIP is referring to is the belief, popularized by the Duggars, among others, that the regular non-emergency pill will cause abortions.

sorry, I misunderstood

will try and get you some info about the regular pill - but for now off to work

[Austin]

This is one among many reasons I can't stand J'Chelle & JimBoob. They have spread this crap all over to justify them having eleventy zillion kids and I think they've done great harm with this misinformation. Theoretically possible does =/= main mechanism or one of main mechanisms of BC. It's theoretically possible that millions of things could happen that don't happen.

[browngrl]

Hi,

The primary mechanism of action of the oral contraceptive pill is by preventing ovulation. Other mechanisms of action include (1) endometrial atrophy ( or a thin endometrium) that makes implantation of the fertilized egg LESS LIKELY. It does not make the endometrium "hostile" to implantation. (2)makes the cervical mucus impede the transport of sperm (3)it might change the motion of the fallopian tubes which may impede transport of the egg and sperm.

I think that pro lifers are opposed to the actions of the pill on the endometrium. They believe that if you prevent implantation that is the same thing as abortion. It is an area of some controversy- because it really depends on your personal interpretation of the data. My beliefs are more along the line of Doc Sharon's. I think that since the main action of the pill is to prevent ovulation - most of the time there is NO egg for the sperm to fertilize. During the normal menstrual cycle without the pill, there are times when the endometrium is such that implantation is less likely eg right at ovulation. So if during an unmedicated normal cycle there are times when implantation is less likely do you then have to classify a normal period as an abortion??To me this makes NO sense. Additionally even with the pill - it is possible to get pregnant so here is further evidence that the pill does not prevent implantation it just makes it less likely.

I should also mention the pill has several benefits other than contraception. Here's a list of some benefits from the society of obstet. and gyne. of Canada :

• cycle regulation • decreased menstrual flow • increased bone mineral density (ie less risk of osteoporosis) • decreased dysmenorrhea (ie painful periods)• decreased peri-menopausal symptoms • decreased acne • decreased hirsutism(ie excess hair)• decreased endometrial cancer • decreased ovarian cancer • decreased risk of fibroids • possibly fewer ovarian cysts • possibly fewer cases of benign breast disease• possibly less colorectal carcinoma • decreased incidence of salpingitis (ie infection of the tubes) • decreased incidence or severity of moliminal (ie PMS symptoms) symptoms.

I hope this information is useful to you and I hope I answered the right question this time :)

[VoiP]

This is one among many reasons I can't stand J'Chelle & JimBoob. They have spread this crap all over to justify them having eleventy zillion kids and I think they've done great harm with this misinformation.

While I agree that the Duggars' influence has been pernicious, I doubt my sister would even be familiar with them. She and her husband are conservative Catholics.

The primary mechanism of action of the oral contraceptive pill is by preventing ovulation. Other mechanisms of action include (1) endometrial atrophy ( or a thin endometrium) that makes implantation of the fertilized egg LESS LIKELY. It does not make the endometrium "hostile" to implantation. (2)makes the cervical mucus impede the transport of sperm (3)it might change the motion of the fallopian tubes which may impede transport of the egg and sperm.

Thank you, browngirl; however, without an article from a scholarly journal, my sister would dismiss what you said, as she did me. She has also told me that the (small) chance that implantation would (theoretically) be less likely is enough to make hormonal contraception an immoral choice.

[Austin]

While I agree that the Duggars' influence has been pernicious, I doubt my sister would even be familiar with them. She and her husband are conservative Catholics.

Oh, I didn't mean to suggest that your sister had been influenced by the Duggars. This has been part of the anti-choice repertoire since the pill came on the market. Well, at least since the early 1980s when I was involved in the anti-choice community, it was a frequent topic of conversation. I just meant that I get aggravated when J'Chelle gets on the Today Show and attributes a miscarriage to the pill when she has absolutely no evidence to back that up. Or because only people who have taken the pill have miscarriages, perhaps.

Being that your sister is a conservative Catholic, is it safe to assume she's against all contraception?

[VoiP]

Being that your sister is a conservative Catholic, is it safe to assume she's against all contraception?

That's correct. And I'm not sure she believes that the Pill causes miscarriages; more that, in her opinion, preventing implantation is equivalent to abortion.

[Rosa]

Just ask her if she knows anyone who conceived on the pill. It seems like the fact that you can miss taking it one day, get pregnant, and then go back to taking it faithfully but still end up with a baby means it's not an abortifacient. Definitely not a reliable one.

[Guest Anonymous]

I am a former IVF patient. During my first cycle, 5 embryos were transferred, none implanted in my uterine lining, and I was never considered pregnant during that cycle, however much I wanted to be. During my second cycle, 5 embryos were transferred, one implanted in my uterine lining, and that was when I was considered a little bit pregnant - until 2 days later my hormone levels rose high enough for my reproductive endocrinologist to say I was definitively pregnant. Approx. 9 mos. after that Her Maj was born and thus began an entirely new adventure in my life.

My point is egg meets sperm does not equal pregnancy and baby; egg meets sperm, successfully burrows into uterine lining, helpful hormones and good fortune may equal pregnancy and baby.

Taking Anatomy and Physiology in college made that pretty clear, and I was a D student in that subject (mainly because I hated dissecting fetal pigs).

[masagoroll]

I prefer to think of the sperm as depressed and frustrated. After all, I don't hate my sister, I'm not even mad at her, really. I'm willing to respect the way she lives if she extends the same thought to me.

That sperm is a heathen! I think it is swimming AWAY from an egg! How dare it not fertilize?

[Patsy]

My point is egg meets sperm does not equal pregnancy and baby; egg meets sperm, successfully burrows into uterine lining, helpful hormones and good fortune may equal pregnancy and baby

For some extreme pro-lifers, it's not whether a pregnancy ends that matters to them. If life starts at conception - rather than at implantation - then something that interferes with implantation is against life. But to follow through with that to the conclusion that the pill is bad, is stupid.

The rhythm method could cause lots of fertilised eggs not to implant (if you have sex outside your most fertile period, but your luteal phase (is that what it's called?) just cuts short before a fertilised egg can implant) without you ever knowing it. The pill stops you from ovulating. A pro-life position would be to use the pill, as it prevents ovulation MOST of the time. With the rhythm method, you are probably killing off fertilised eggs, and with no method at all, you have no way of knowing. One of the gripes about the pill killing babies is that you wouldn't know - yeah, well, without any contraception at all you ALSO don't know.

[VoiP]

For some extreme pro-lifers, it's not whether a pregnancy ends that matters to them. If life starts at conception - rather than at implantation - then something that interferes with implantation is against life.

This is what my sister has told me she believes.

The rhythm method could cause lots of fertilised eggs not to implant (if you have sex outside your most fertile period, but your luteal phase (is that what it's called?) just cuts short before a fertilised egg can implant) without you ever knowing it. The pill stops you from ovulating. A pro-life position would be to use the pill, as it prevents ovulation MOST of the time. With the rhythm method, you are probably killing off fertilised eggs, and with no method at all, you have no way of knowing. One of the gripes about the pill killing babies is that you wouldn't know - yeah, well, without any contraception at all you ALSO don't know.

I didn't know that. Interesting.

Edited for

:angelic-whiteflying: :angelic-whiteflying:

[Effie]

This is what my sister has told me she believes.

Well, you said that she's a catholic, right? Even the Catholic Church (officially) states that "life" (human life) does not actually begin until 40 days after conception.