Transcript of Presented by Scott & Laura Schulze The Science Behind Hormonal Contraceptives Pro-Life Symposium &...
- Slide 1
- Presented by Scott & Laura Schulze The Science Behind
Hormonal Contraceptives Pro-Life Symposium & Technology
Symposium Saturday, September 19, 2009 Dayton Engineers Club
Dayton, OH
- Slide 2
- Overview How the Body Naturally Works History of Hormonal
Contraceptives How Contraception Unnaturally works What does
Planned Parenthood say about Hormonal Contraceptives Healthy
Alternatives to Contraceptives
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- Overview How the Body Naturally Works History of Hormonal
Contraceptives How Contraception Unnaturally works Planned
Parenthood & Hormonal Contraceptives Healthy Alternatives to
Contraceptives
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- The Female Reproductive System
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- Endometrium Luteininzing Hormone (LH) Pituitary Gland
Follicle-Stimulating Hormone (FSH) Ovaries Estrogen Cervix
Pituitary Gland Ovulation Progesterone
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- How the Body Naturally Works Three things necessary for
Conception of baby (embryo) Sperm Egg Cervical Mucus Helps healthy
sperm reach egg Implantation onto Uterine Wall is necessary for
baby (embryo) to survive
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- Overview How the Body Naturally Works History of Hormonal
Contraceptives How Contraception Unnaturally works What does
Planned Parenthood say about Hormonal Contraceptives Healthy
Alternatives to Contraceptives
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- History of Hormonal Contraceptives 1550 BC Egyptian Papyrus
mentions the use of Crocodile Dung before intercourse Ancient
Arabian documents mention the use of Elephant Dung mixed with Honey
Incas, Myans, Aztecs used roots of plants like mandragora Also used
in ancient times were: Seeds of Queen Annes Lace, Wild Carrot,
Pennyroyal, Artemisia, Myrrh, Rue, Pomegranate Seeds
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- History of Hormonal Contraceptives 7 th Century BC the Silphion
Plant from Cyrene Silphion is a Giant Fennel plant Contraceptive
& Abortifacient Only grew in a 125 mile x 30 mile stretch of
Libya Over harvesting led to increase in value worth its weight in
silver Extinct by 2 nd Centruy AD Asafoetida (used in
Worcestershire Sauce) Cheaper but less expensive alternative to
Silphion
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- History of Hormonal Contraceptives Silphion Plant from Cyrene
on an ancient coin. The plant created a huge economic boost for
Cyrene The usage of the Silphion is implied
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- History of Hormonal Contraceptives 1873 Congress passes
Comstock Law birth control illegal 1914 Eugenics advocate Margaret
Sanger coins term birth control in her journal The Woman Rebel,
flees country to avoid lawsuits 1918 The Crane Decision allows
birth control for therapeutic purposes 1921 Margaret Sanger forms
American Birth Control League (Planned Parenthood Federation of
America)
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- History of Hormonal Contraceptives 1921 Haberlandt showed that
transplantation of ovaries of pregnant rabbits into fertile female
rabbits suppressed their ovulation and fertility 1944 The effective
hormone was found to be progesterone 1936 Margaret Sanger
orchestrates court battle which results in legitimizing birth
control and official recognition by AMA 1938 Inhoffen & Hohlweg
synthesized Ethinyl-Oestradiol
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- History of Hormonal Contraceptives 1941 Russel Marker makes
Synthetic Progesterone with Mexican wild yams (cabeza de negro)
1951 Margaret Sanger has 200 birth control clinics 1951 Margaret
Sanger asks Dr Greg Pincus to create a contraceptive pill 1951/1954
Carl Djerassi creates pill form of synthetic progesterone 1952
Frank Colton develops a pill form of synthetic progesterone 1953
Margaret Sanger secures funding for Dr Pincus to continue
development of a contraceptive pill
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- History of Hormonal Contraceptives 1954 Dr Pincus & Dr John
Rock begin first human trials of their pill (high dose) in Boston
under guise of a fertility study due to anti-birth control laws in
US The study uses 21 days of pill + 7 days off to allow for
menstruation so the pill will seem natural 1955 Conclusive results
of study announced 1956 Clinical testing of Enovid begin in San
Juan, Peurto Rico due to anti-birth control laws in US. Pills made
by G.D. Searle 3 Women died + 17% had side effects but no action
taken
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- History of Hormonal Contraceptives 1957 Enovid submitted to FDA
for menstrual disorders ( GD Searle ) 1959 Dwight Eisenhower Birth
Control is not our (govt.) business 1960 Enovid submitted to FDA as
a contraceptive (what is was actually developed for) First drug in
history to be given to a healthy person for long-term use 1960
Enovid approved by FDA as a contraceptive
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- History of Hormonal Contraceptives 1961 Anovlar First European
oral contraceptive introduced 1962 G.D. Searle (Enovid) receives
reports of dangerous side effects 11 Deaths, Blood Clots, Heart
Attacks no action taken Complaints dismisses as exaggerated
Considered the price women had to pay for a contraceptive 1962
Ortho Novum hits US market. Other pills follow 1964 Lyndon B.
Johnson pushes legislation for federal support of birth control for
the poor
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- History of Hormonal Contraceptives 1965 Griswold v. Connecticut
US Supreme Court rules prohibition of birth control sales is
violation of right to privacy 1967 NAACP accuses Planned Parenthood
of racial genocide 1969 A Doctors Case Against the Pill (Barbara
Seaman) published 1970 After Congressional hearings, information on
side effects of the pill are included in the packaging 1972
Eisenstadt v. Baird US Supreme Court rules against the prohibition
of birth control sales to single women 1974 Govt. supports Birth
Control clinics in 2,379 counties (77%) 1980s Low dose birth
control pills introduced. Original high dose pills removed from
market
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- History of Hormonal Contraceptives 1990 FDA approved Norplant
2002 Norplant removed from US market 2002 FDA approved Norplant-2
1999 FDA approved Plan B (Emergency Contraception) 2000 FDA
approved RU-486 (Abortion Pill) 2000 FDA approved Mirena 2001 FDA
approved Nuva-Ring 2001 FDA approved Ortho Evra Patch 2004 FDA
approved Depo-Provera 2007 FDA approved Lybrel
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- Overview How the Body Naturally Works History of Hormonal
Contraceptives How Contraception Unnaturally works What does
Planned Parenthood say about Hormonal Contraceptives Healthy
Alternatives to Contraceptives
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- Birth Control Pills Three Kinds: Mini-pill progestin only
Combination progesterone and estrogen Seasonale longer cycling Used
by 10 million women in the United States, 4 million are 25 years
old and younger.
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- 4- Pronged Attack on a Womans Fertility 1) Prevents ovulation
from occurring. (Prevents release of egg from ovary.) 2) Dries up
mucus so that sperm can neither live in vaginal environment nor
enter the cervix. 3) Changes the lining of the uterus so that the
tiny baby boy or girl cannot implant and grow. CHEMICAL ABORTION 4)
Lowers efficiency with which the fallopian tubes propel eggs from
ovaries to uterus.
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- Common Side Effects of Birth Control Pills Nausea and vomiting
(in about 10% of users) Symptoms of PMS: fatigue, breast
tenderness, irritability, difficulty concentrating,
headaches/migraines, bloating/weight gain/water retention Mood
swings, depression Weight loss Loss of sex drive Mid-cycle bleeding
Dysmenorrhea (painful menstruation) Amenorrhea (absence of
menstruation) Vaginitis and vaginal infections Temporary or
permanent infertility when discontinuing Pill
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- Risks Associated with Birth Control Pills Blood clots MI,
Stroke, Pulmonary Embolism, Renal Artery Thrombosis & Kidney
Damage, Temporary/Permanent Blindness OCP use and obesity: DVT risk
increased 10 fold Hispanic women with hx of GDM thrombosis risk WHO
Study: Migraines associated with increased risk of cerebral
thromboembolism Smokers over age of 35 heart disease, MI, stroke
Mild elevation of blood pressure (hypertension) Cancer of the
Breasts and Cervix NIH: Estrogen is a known human carcinogen.
2002
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- Contraindication of Birth Control Pills Cannot be used by those
with a history of: Breast cancer Blood clots or risk to develop
blood clots Liver disease Kidney disease Unexplained uterine
bleeding Smokers over age 35, Melanoma (a type of skin cancer)
Those on certain medications (e.g. antibiotics)
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- Ortho-Evra Square patch that slowly releases a combination of
estrogen and progestin hormones through the skin. Worn for three
weeks, off for one week Same mechanism of action, side effects and
risks as the pill Can cause rash or skin irritation at site of
patch Seems to be less effective than the Pill
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- FDAs Approval of the Ortho Evra Patch Prior to the FDA approval
of 'The Patch' in November 2001, an FDA medical reviewer took
exception with the manufacturer's conclusions regarding two cases
of blood clots in the lung affecting two, rather young participants
in the Ortho Evra clinical trials. (the reviewer) DOES NOT AGREE
WITH THE SPONSOR'S [Ortho-McNeil] ABOVE CONCLUSIONS. The two cases
of pulmonary embolus, a serious and potentially fatal condition,
must be counted as two cases in the group. Despite the warning, the
FDA gave Ortho Evra approval. July 2005, an investigation by the
Associated Press exposed that 17 of the 23 deaths associated with
the use of the Ortho Evra birth control patch appeared to be
related to the formation of blood clots. November 2005, four months
after the Associated Press report, the FDA fostered a label change
to the product, indicating the increased risk of blood clots, and
representing double the risk of clots for women taking The
Pill.
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- Nuva Ring Thin, transparent, flexible ring inserted into the
vagina where it slowly releases estrogen and progestin hormones
into the body. Left in for three weeks, out for one week Same
mechanism of action, side effects and risks as the pill and patch
Can cause vaginal irritation and discharge
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- Depo-Provera Most widely-used contraceptive injection in the
world that lasts three months. Mechanism of Action Prevents
pregnancy by inhibiting ovulation Prevents pregnancy by inhibiting
ovulation Abortifacient: alters normal growth of endometrium and
prevents implantation of newly conceived baby Abortifacient: alters
normal growth of endometrium and prevents implantation of newly
conceived baby Reduced Bone Density Amenorrhea, Headaches, Weight
Gain, Low Birth Weights Increased Risks for Breast Cancer and STDs
Delayed return in fertility (up to 18 months) Risk of Breast Cancer
tripled if use the shot for at least 2 years before age of 25.
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- Five or six silicone rods surgically inserted into arm,
releasing hormones into the bloodstream and lasting for five years.
Withdrawn from US market in 2002 Birth Control Implants Norplant A
thin rod inserted under the skin of the upper arm, containing a
synthetic hormone that is released into the body over three years.
Same mechanism of action as Pill. Pain at insertion site, acne,
increased BP, increased clots, irregular bleeding
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- Emergency Contraception Known as the morning-after pill, EC is
a high dosage of the birth control pill. Plan B is used to prevent
pregnancy after an unprotected sexual encounter. It works by
delaying ovulation and fertilization, and perhaps preventing
implantation in the uterus. It does not terminate an established
pregnancy. (According to the ACOG definition of pregnancy)
Progestin-only EC Nausea and vomiting Breast tenderness Ectopic
pregnancy Blood clot formation
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- RU-486 Mifepristone + Misoprotol Referred to as the abortion
pill but is actually a process of consuming multiple pills Man-made
steroid designed to work against a womans normal, natural state
during pregnancy. First visit RU486 pills given to kill baby Second
visit Misoprostol pills/suppositories given in attempt to expel the
dead baby Final visit If RU486 failed, surgical abortion scheduled
Side effects: nausea, abdominal pain, vomiting, heavy and extended
bleeding, heart attack, hemorrhage, impaired future fertility
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- FDAs Approval of RU-486 FDAs Approval of RU-486 (developed by
the Population Council) The median total review time for new drug
applications is 14.8 months FDA review time for RU-486 was 6
months. FDA quickly approved RU-486 on fast track process reserved
for drugs used for life threatening diseases RU-486 Expedited
Clinical Trials 3-8% Unsuccessful Pain, Nausea, Cramps, Bleeding,
Vomiting 3% Required Blood Transfusions or Surgery Several Maternal
Deaths linked to RU-486 A similar abortion drug was secretly tested
in Philippines & Mexico as tetanus vaccine
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- Intra-Uterine Devices A small, flexible, plastic t-shaped
device that contains either copper or the hormone progesterone and
is inserted into the uterus by a clinician to prevent pregnancy.
The UID can be left in place for 1 to 10 years, depending on the
type of IUD.
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- Intra-Uterine Devices How It Works: Kills sperm before they
reach the ovum, affecting cervical mucus Inhibits implantation IUD
containing progesterone also can inhibit ovulation to some
degree
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- Intra-Uterine Devices Increased risk of miscarriage
(spontaneous abortion) Ectopic (extrauterine) pregnancies 10 times
above usual incidence Pelvic inflammation that can cause sterility
Anemia due to excessive menstrual bleeding Embedding, migration of
fragmentation of IUD Spotting or prolongation of menstrual flow
Increased risk of infection Occasional perforation of uterus,
cervix, or bladder requiring surgery Backache Copper toxicity
poisoning of the organs Localized pain that persists each time
ovulation occurs
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- Overview How the Body Naturally Works History of Hormonal
Contraceptives How Contraception Unnaturally works What does
Planned Parenthood say about Hormonal Contraceptives Healthy
Alternatives to Contraceptives
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- What does Planned Parenthood have to say about Oral
Contraceptives? Quotes from Margaret Sanger, Eugenics Promoter
& founder of Planned Parenthood: More children from the fit,
less from the unfit that is the chief aim of birth control Birth
Control Review, May 1919 The most merciful thing that a large
family does to one of its infant members is to kill it Women and
the New Race, 1920 (The purpose in promoting birth control) to
create a race of thoroughbreds Birth Control Review, November 1921
Couples should be required to submit applications to have a child
Birth Control Review, April 1932
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- What does Planned Parenthood have to say about Oral
Contraceptives? (pregnancy is) an episodic, moderately extended
chronic condition may be defined as an illnesstreated by evacuation
of the uterine contents Dr. Warren Hern, Is Pregnancy Really
Normal? Family Planning Perspective, Planned Parenthood vol 3, no
1, Jan 1971, pg1. If your parents are stupid enough to deny you
access to birth control, and you are under 18, you can get it on
your own. Call Planned Parenthood Ad in Dallas Observer, Jan 30,
1986 No. You do not need your parents permission to get birth
control at Planned Parenthood, and we will not tell your parents
that we have seen you. At Planned Parenthood all of our services
are confidential (for) teens age 12 and older. Article on Planned
Parenthood website
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- What does Planned Parenthood have to say about Oral
Contraceptives? Today, we have many safe and effective birth
control methods available to us PlannedParenthood.org Do Combined
Oral Contraceptives delay a womans return to fertility? NO:
International Planned Parenthood website YES: 1 to 2 month delay:
PlannedParenthood.org
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- What does Planned Parenthood have to say about Oral
Contraceptives? Do IUDs, Implants or Injectibles cause Abortions?
International Planned Parenthood NO PlannedParenthood.org There is
no Proof this actually happens: American College of Obstetricians
& Gynecologists (ACOG.org) Hormonal IUD thins the lining of the
uterus. This keeps a fertilized egg from attaching.Copper IUD can
prevent the egg from attaching to the wall of the uterus.
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- What does Planned Parenthood have to say about Oral
Contraceptives? A main reason people use contraception? A smaller #
of children better quality of life: International Planned
Parenthood More kids Happier marriage: San Francisco University
study Very Happy3.25 Pretty Happy2.98 Not Too Happy2.46 % Very
Happy7+ kids (74%)1-6 kids (58%)
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- Overview How the Body Naturally Works History of Hormonal
Contraceptives How Contraception Unnaturally works What does
Planned Parenthood say about Hormonal Contraceptives Healthy
Alternatives to Contraceptives
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- Healthy Alternatives to Hormonal Contraceptives Effectiveness
Rates Nothing 15% Spermicide 74% Withdrawal 81% Condom 84~85% Oral
Contraceptive (pill) 92~95% IUD 98~99% Sterilization 99+% NFP 99+%
Abstaining 100%
- Slide 44
- Comparison of Artificial Methods of Birth Control and The
Ovulation Method U.S. Statistics 1992
- Slide 45
- BleedingDry Days Ovulation Pre-ovulatory relatively Infertile
phase Post-ovulatory Infertile phase Fertile phase Natural Family
Planning
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- Why Use NFP? Safe - 100% natural - Has no health risks - Does
not involve potentially harmful birth control drugs or devices
Healthy - It teaches a woman to become aware of her normal
fertility pattern. - Changes in a womans fertility pattern can
alert her to possible medical problems.
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- Advantages of Using NFP Can be used to achieve or avoid
pregnancy Effective in all reproductive circumstances: Regular or
irregular cycles Breast feeding Pre-menopause Etc... Early
detection and diagnosis of fertility disorders Immediately
reversible No alteration of physiology No side effects Not
technology dependant, no harmful devices
- Slide 48
- Advantages of Using NFP Easy to Learn Easy to Use Minimal Cost
Involves the Couple Morally Acceptable More satisfying marriages
Divorce rates: 50% vs. 2%
- Slide 49
- U.S. Studies on Method Effectiveness of the Ovulation Method
StudyYearCouplesCyclesPreg. rate St. Cloud197426018230.6%
Dolack197832933541.1% Klaus, H et al. 1979109012,2821.17% Klaus,
H1981728080% Wilson, M (Guatemala) 1997- 1999 93710,8720.65%
- Slide 50
- Resources American Life League www.all.orgwww.all.org Billings
Ovulation Method Assn www.Boma-usa.orgwww.Boma-usa.org Breast
Cancer Prevention Institute
www.bcpinstitute.orgwww.bcpinstitute.org Couple to Couple League
www.ccli.orgwww.ccli.org International Planned Parenthood
www.ippf.orgwww.ippf.org Family of the Americas Foundation
www.familyplanning.netwww.familyplanning.net National Institute of
Health www.nih.govwww.nih.gov One More Soul NFP Center
www.OMSoul.comwww.OMSoul.com Pope Paul VI Institute
www.popepaulvi.comwww.popepaulvi.com Planned Parenthood
www.plannedparenthood.orgwww.plannedparenthood.org University of
San Francisco www.userwww.sfsu.eduwww.userwww.sfsu.edu World Health
Organization www.who.intwww.who.int