Could use of the pill be linked to insulin resistance?

Birth Control, Coming off the pill, Health Care, New Research

Adapted from a photo by anna marie-grace // CC 2.0

The pill is one of the most intensely studied drugs in history, and believed to be among the safest – safer than aspirin, as an editorial in the American Journal of Public Health noted twenty years ago. Yet young women seem to be quitting in droves, for a variety of reasons: to restore feelings of psychological and emotional health, regain lost libido, relieve cardiovascular symptoms and disorders, or ease anxiety about these or other health issues.

When women report these side effects of birth control pills, physicians often recommend they try another brand, but many of these side effects are common to hormonal birth control, especially oral contraceptives. A new study published this month in Human Reproduction suggests there may be yet another common side effect: Researchers in Finland found that oral contraceptives may worsen insulin sensitivity and are associated with increased levels of circulating inflammatory markers.

The study was very small and ran only for a short time, so drawing conclusions is premature, but since the beginning of the year, I’ve been following several online discussions of young women quitting the pill. Although I have yet to see development of Type 2 diabetes or insulin resistance cited as a reason to quit the pill, I have seen such a variety of health issues and medical problems described that this study caught my eye immediately. Current estimates indicate that 12.6 million, or 10.8 percent, of all U.S. women ages 20 years or older have diabetes (diagnosed and undiagnosed). Could it be related to their birth control? Perhaps in those already genetically predisposed.

Research from the Guttmacher Institute indicates nearly 60% of pill users take it for non-contraceptive reasons, such as for cramps or other menstrual pain, menstrual regulation, acne, endometriosis, as well as for prevention of unintended pregnancy. Fourteen per cent of US pill users (more than 1.5 million women) take birth control pills solely for non-contraceptive reasons. If the Finland study proves to hold true for larger groups over extended periods, there’s another reason to be more cautious prescribing the pill.

 

What do men know about birth control and periods?

Birth Control, Men, Menstruation, New Research, Sex

Here’s a hint: the title of the new study by the National Campaign to Prevent Teen and Unplanned Pregnancy is How Misperceptions, Magical Thinking, and Ambivalence Put Young Adults at Risk for Unplanned Pregnancy.

The study [PDF] surveyed American singles ages 18–29 about their perceptions about and use of contraception. Twenty-eight percent of young men think that wearing two condoms at a time is more effective than just one. Twenty-five percent think that women can prevent pregnancy by douching after sex. Eighteen percent believe that they can reduce the chance of pregnancy by doing it standing up.

A staggering 42% of men and 40% of women believe that the chance of getting pregnant within a year while using the birth control pill is 50% or greater (despite research suggesting that the pill is typically 92% effective).

And many unmarried young adults believe they are infertile. Although available data suggest that about 8.4% of women 15–29 have impaired fecundity (measured as an inability to conceive or carry a baby to term): 59% of women and 47% of men say it is at least slightly likely they are infertile (19% of women and 14% of men describe it as quite or extremely likely.

In a very good short essay about the study at The Sexist, Amanda Hess links men’s lack of knowledge about contraception to their lack of knowledge about menstruation and physiology more generally, and illustrates with some telling anecdotes. There are a few more examples in the video at right, in which Amanda corners several men and asks them to explain how hormonal birth control works.

It all seems quite shocking, until one remembers that abstinence-only sex education that includes lessons about the ineffectiveness of condoms and other contraceptives has been standard in the U.S. since 1996. (See here for U.S. Government definitional criteria for abstinence-only sex education. At present, 22 states have opted out of receiving federal funding, so that they may provide accurate and comprehensive sex education.)