The Pill: The Case For More Knowledge

Press, Volume CX, Issue 32382, 22 August 1970, Page 4

The Pill: The Case For More Knowledge

The Doctors’ Case Against The Pill. By Barbara Sleaman. Michael Joseph. 279 pp. (Reviewed by J.V.A.) Do the women taking it know enough about “the pill?” And do the doctors prescribing it know enough about it too? Mrs Sleaman, an American medical writer, gives a very definite no to these two questions in her very purposeful attack on the controversial contraceptive. Helped by a skilled research team, Mrs Sleaman has made a wide investigation into the subject and quotes numerous doctors and case histories of mainly unidentified patients to support her theme that is that none of the currently available oral contraceptives are as safe or as effective as was once hoped. “If you are in the habit of unthinkingly reaching for the pill when you finish brushing your teeth each night, this book should be on your required reading list,” recommends Hugh J. Davis, a distinguished American obstetrician and gynaecologist, in an introduction to the book. He states that the fact that .there are definite and measurable risks of significant proportions can no longer be denied: In the eyes of many doctors, the risks of the drug, have always been acknowledged but were outweighed by the huge social problems of over-population, unwanted pregnancies and unwanted children. But now it has become clear that rather than saving underdeveloped countries from starvation or solving welfare problems in countries like the United States, the pill is “saving the saved.” Its most loyal users are middleclass women, who, by and large, have been fairly successful in controlling their fertility for many years. Mrs Sleaman sees the deceptively easy act of swallowing the inno-cent-looking pill as an act of uninformed consent. Very few worn are more than vaguely aware of the alter- • natives something that she puts right with a concise and informative section at the end of her book. And few of them have any idea of the potency of the

drugs they are ingesting and how the pills may affect their own health or that of their unborn children. Who is to blame? The women who don’t know any better? Overworked doctors who have not got the time to keep up with the latest research into the pill and who in any case do not like to “worry” their patients with warnings? Or the manufacturers with their flower-bedecked, carefully-worded little pamphlets? The author is not so much concerned with attributing the blame as to presenting her case to the public. She rather ambitiously describes her report as “a pioneering public service with the highest possible goal: to preserve human life.” But although her indictment is a formidable one, many of the surmises and possibilities put forward are as yet unproven. This does not mean that they should be dismissed as alarmist. Few women can have escaped hearing disconcerting whispers about the pill and many must be suffering the discomfort of side-effects unaware of their origin. It is vital that they should know of the risks they are taking even if they reply in the same vein as a patient in the book who, when warned of the risk of cancer, replied: “I don't care if you promise me cancer in five years, I’m staying on the pill. At least I’ll enjoy the five years I have left. “For the first time in 18 years of married life I can put my feet up for an hour and read a magazine. I" can watch my favourite television programme without having to catch up on my ironing at the same time. I can usually get a full night’s sleep because there’s no baby to feed or toddler to take to the toilet. If you refuse to give me the pill, I’ll go get it from someone else.” According to some estimates only 3 per cent of all pill users remain completely free of all side effects. Bloodclotting is one of the most frequent and most dangerous and the pill can also cause strokes and other neurologic or eye difficulties. Other possible effects mentioned include epilesy, mild chorea (St Vitus’s dance), heart disease, diabetes, jaundice, skin changes, arthritis-like symptoms, breast changes,

hair loss, teeth and gum problems, facial hair, hearing and voice changes, not to mention the strain of always feeling pregnant or pre-menstrual. Apparently it is now recognised that the hormones in the pill affect virtually every system of the body and may produce extremely bizarre responses. The evidence seems to point towards a link between the pill and cancer, but the link is still unproven. By the early 1970 s the pill will have been in widespread use for a decade, the minimum time it takes most cancer to develop in most humans, and some researchers believe that' by then the long-term effects of the pill may set off a cancer epidemic. Only future generations will be able •to determine whether or not a pill taken today will affect children in generations to come through genetic changes, but a Canadian doctor has already found a striking increase in a rare chromosomal defect among the babies of women who conceive within six months after going off the pill. And an American gynaecologist has discerned a significant increase in miscarriages and abnormalities in babies in a group of‘women who had used the pill before becoming pregnant. Psychiatrists have noticed that adverse emotional reactions to the pill range from suicidal and even murderous tendencies to increased irritability and tearfulness. A British investigation revealed that one out of every three pill users studied showed depressive personality changes. Tragically some doctors still give patients tranquillisers to counteract pill-caused psychiatric symptoms even though researchers have learned that the combination of the pill and certain psychiatric drugs can produce a broad range of dangerous and unpleasant effects. “Again and again, we heard of cases where the inability of busy practitioners to keep up with the volume and variety of negative l scientific reports about the pill was potentially threatening to human life,” says Mrs Sleaman. A decrease in sex drive is apparently far more common in pill users than is an increase and it is an established fact that a certain number of women are found to be sterile after they stop taking the pill. Apparently most young women who suffer from this “oversuppression syndrome" can be cured in time, but in other cases nothing can be done for the patient apparently because the pill has destroyed the lining of her uterus. It is hot really surprising to learn that studies. indicate that one woman in three gives up the pill by the end of the first year, and one woman in two gives it up by the end of the second year — ■ for reasons other than a desire to become pregnant. But what of the others? They should at least be aware of the risks involved even if they are prepared to discount them.