Blog of the Society for Menstrual Cycle Research

Is the birth control pill a cancer vaccine?

March 11th, 2014 by Holly Grigg-Spall

I’d given up reading the comments on online articles for the good of my mental health when a small slip last week steeled my resolve. In response to an article exploring the arguments made by “birth control truthers” a concerned father decided to have his say, taking the defensive arguments put forward by those in opposition to these “truthers” to their only logical conclusion:

“Perhaps we should market contraceptive pills as hormonal supplements to reduce cancer risk instead of as “contraception”? After all, it is only in modern times that women have hundreds of menstrual cycles throughout their lives. Even up until 1800 it was common for women to be either pregnant or lactating throughout much of their short lives.

The body simply wasn’t built to handle so many menstrual cycles, which raises the risk for cancer.

Who could argue with taking supplements to prevent cancer?

This may sound strange, but I am seriously considering putting my 11 year-old daughter on the pill (with no placebo) just for the health benefits. I just have to convince my wife first who is a little shocked by the idea…”

I cannot count how many times I have heard that the birth control pill “prevents cancer” – specifically “preventing” ovarian and endometrial cancer.  In the last few months I have seen references to this benefit explained less and less so as a “lowered risk” and more and more so as a “preventative” action.  I think this is significant as the word “prevent” suggests that the pill guarantees you will not get these forms of cancer. And yet, to remark that the pill is counted as a carcinogenic substance by WHO – due on the increased the risk of breast and cervical cancers – will get you tagged as a “truther.”

What is interesting, of course, is that despite the “cancer protecting” benefits of pregnancy, and early pregnancy at that, we do not see women encouraged to get pregnant in order to lower their risk of ovarian cancer.  Criticism of child-free women does not generally include comments about their lax attitude towards their own health. The risk goes down further with every pregnancy and further still with breast feeding, especially breast feeding for a long period of time after birth. Women who have children young, and multiple children, have a lower risk of breast cancer than women who have no children or children after 30. Yet we see more talk of women having “too many” children at an age that is “too young” – in fact I was contacted via Twitter by someone who read this piece and who saw, in the comments, that one woman who uses natural family planning admitted to both liking the method and having 14 children. This admission disgusted the person who contacted me, even when I pointed out that it seemed the woman had very much chosen to have those 14 children.

It seems the people who are advocating prescription of the pill for cancer prevention purposes are not advocating women have children earlier, more children, or consider breast feeding for the good of their own health – in fact two of the loudest critics of my “birth control truther” book are vehemently against pregnancy and breast feeding being part of women’s lives (Amanda Marcotte and Lindsay Beyerstein). The risks of the pill are frequently compared to the health risks associated with pregnancy and child birth,  but we don’t often hear women say they are choosing to not have children to avoid putting their health at risk for nine or so months.

Which leads me to this article in the LA Times that suggested nuns should also be on the birth control pill for its cancer-protecting abilities:

“And are the pills really unnatural? Our hunter-gatherer ancestors had their babies four or five years apart, because of long intervals of breastfeeding. As a result of that and their shorter life spans, they had as few as 40 menstrual cycles in a lifetime, while a modern woman can have 400. Though we can’t claim that today’s pills are perfect, their use is certainly less unnatural than enduring the hormone turmoil of hundreds of menstrual cycles.

This brings us back to the Colorado nuns, the Little Sisters of the Poor. Nuns have a substantially higher risk of reproductive cancers than women who have children, in part because of their celibacy, which means a lifetime of uninterrupted menstrual cycles. In 2011, my wife and I attended an obstetric conference in the Pontifical University of the Holy Cross in Rome. The keynote lecture there recommended that nuns use oral contraceptives for two or three years after taking their vows, in order to benefit from a long-term reduction in reproductive cancers to which nuns are otherwise exposed by their celibate life.”

Of course, no one would suggest nuns should give up on God and get pregnant, despite the fact that their increased risk comes from not having children or breast feeding, anymore than the father of that 11 year-old would likely encourage his daughter to have multiple children before she hits 30.

Coming Off The Pill: A Mind Map Guide

March 7th, 2012 by Laura Wershler

Everybody can use a good map to help them get to where they’re going. Why not women heading to the land of non-hormonal contraception?

In my post on January 11, 2012 I asked if coming off the pill was a growing trend. I proposed to write a series of posts about the issues associated with the decision to stop using hormonal birth control.  For the purposes of this discussion assume that “coming off the pill” refers to quitting any method of hormonal contraception including the pill, patch, ring, shot, implant or Mirena intrauterine system.

As I was preparing a list of possible topics, I realized that one way to represent the complexity of issues involved in this decision is with a mind map: “a diagram used to represent words, ideas, tasks, or other items linked to and arranged around a central key word or idea.” It also occurred to me that readers could then add to this schematic, filling in important points based on personal or professional experience. So I got out my colored markers, did a little brainstorming and came up with Coming Off the Pill: Mind Map 1.0. I invite readers to comment, offering additions under the key headings I’ve noted and suggesting other categories that should be included.  Could this become a talking, planning or process guide for women considering the transition to non-hormonal birth control methods?

If you’ve thought about or been through the experience of quitting hormonal contraception, or if you’ve helped others through the experience, please contribute to the development of Coming Off The Pill: Mind Map 2.0 by posting your comments and suggestions. (I’ve already thought about other headings I could have included.) Besides providing me with a guide for writing future posts, what other ways can you imagine this mind map might be used?

The pill, reduced period pain and the ongoing delusion

January 20th, 2012 by Laura Wershler

Is there a woman over the age of 18 anywhere who doesn’t know that taking the birth control pill can make her periods lighter and less painful? Most women know this, but not many know why. The news stories swirling around a new study about the pill and period pain will not enlighten them.

Photo credit: Ceridwen, Creative Commons 2.0

A 30-year longitudinal Swedish study has finally proved the worth of what is accepted practice in North America and Europe: the prescribing of combined oral contraceptives (COCs), or birth control pills with synthetic estrogen and progestin, to treat painful periods known clinically as dysmenorrhea.

Of course, pharmaceutical companies that manufacture COCs are probably eager for this research, as prescribing the pill for dysmenorrhea is still an off-label use in the U.S. (unlicensed use in the U.K.). Pill manufacturers may be able to use this finding to lobby the FDA (or equivalent agencies in other nations) to approve the pill as treatment for menstrual pain, leading to increased sales and insurance coverage. Perhaps that’s why news media have been treating this discovery as breaking news.

Take this headline: Yes, the Pill CAN ease the agony of period pain: Scientists confirm what millions of women already know, or this one: The pill ‘does ease period pain’, or this one: Combination oral contraception pills cut menstruation pain, or, really, any of these.

You can read the abstract of the study by Swedish researchers Ingela Lindh, Agneta Andersson Ellström and Ian Milsom, published this week in the journal Human Reproduction, here: The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study. The conclusions are simple: “COC use and increasing age, independent of each other, reduced the severity of dysmenorrhoea. COC use reduced the severity of dysmenorrhea more than increasing age and childbirth.”

Forget the age factor for the purposes of this discussion. The fact that COC use reduces the severity of dysmenorrhea is not astounding. This is old news. So says Dr. Steven Goldstein, an obstetrician/gynecologist at NYU Langone Medical Center in New York City, quoted in a USA Today story:

“The study results are not surprising. It’s gratifying to see researchers documenting scientifically what practitioners have been seeing for a very long time. The amount of discomfort from a woman’s period with a combination birth control pill is a fraction of what it is without the Pill. There is a diminution of pain from the Pill.”

What is astounding is what Dr. Goldstein, and other OBGYNs, didn’t say in responding to the study. That the reason the pill reduces menstrual pain is because the synthetic hormones in the pill shut down a woman’s own menstrual cycle. The “period” women experience when on the pill is technically known as a “withdrawal bleed,” brought on by seven days of placebo pills. While it feels like a period to menstruators, it is not the same physiologically as the period they experience when NOT on the pill. That’s why it doesn’t hurt as much.

The point is, the pill is too often credited with regulating the menstrual cycle. It does no such thing. The pill does not regulate any woman’s menstrual cycle; it supercedes it. This research, and the many news stories that reported it, once again ascribe power to the pill – this time the power to cut menstrual pain. This is an incomplete truth.

Is Coming Off the Pill a Growing Trend?

January 11th, 2012 by Laura Wershler

The Internet abounds with articles, posts and forum discussions about coming off the birth control pill. Women are looking for information and advice. Many are trying to get pregnant, others are just done with hormonal contraception.

It’s a topic that interests many of us connected to the Society for Menstrual Cycle Research (SMCR) because of

Created at an a menstrual arts and crafts event, Andrea, 25, said this piece depicts the multiple emotions she feels around menstruation. Photo by Laura Wershler

how the pill and other forms of hormonal contraception impact the menstrual cycles of the women who take these medications. Some of us are experts in menstrual cycle function and dysfunction, most are advocates for healthy, positive menstrual cycle experiences from menarche to menopause.

A recent blog post at on the topic of quitting the pill caught our members’ attention.  Re: Cycling blogger Elizabeth Kissling included the post in Weekend Links on November 19.

A young woman in Paris was looking for advice and comments from other blog readers about how to manage the effects of coming off the pill. Siobhan O’Connor, the blog co-editor, shared Paris girl’s story with a graceful, inclusive invitation to readers:

There’s no judgment—implicit or explicit—on anyone who is on or has been on birth control pills. Some people love them, some people have to take them for medical reasons, some people abhor them. Here, we want to talk candidly about what happens when you go off them. Because, whoa. That can be hectic.

The post drew over 80 comments, with a few coming from SMCR members. What struck me was how many women:

1)  had already ditched the pill or were planning to
2) expressed a desire for the return of regular, normal menstrual cycles
3)  were concerned about their skin (it often breaks out after quitting the pill).

SMCR member, endocrinologist and guest blogger Dr. Jerilynn Prior answered the concerns about acne and bad cramps in a comment posted on November 22, and included a link to Centre for Menstrual Cycle and Ovulation Research website where readers can find information about all things related to menstrual cycle health.

Holistic Reproductive Health Practitioner Geraldine Matus, another member, commented on November 26 that it was concerns and experiences like those expressed by posters that prompted her and colleague Megan Lalonde to write the guide: Coming Off the Pill, the Patch, the Shot and Other Hormonal Contraception.

I invited No More Dirty Looks readers to visit this blog to learn more about the menstrual cycle and the issues raised by their online discussion.

Regular visitors to re: Cycling know that we cover a broad range of topics, but bloggers frequently address hormonal contraception as it relates to women’s health issues.

Check out this sampling from the re: cycling archive:

Several of the women who responded to the Paris girl post at expressed eagerness to reclaim healthy, ovulatory menstruation and a willingness to learn how to  manage their fertility without the aid of hormonal contraception.

Over the next few months, I intend to explore many aspects of the coming-off-the-pill experience through personal stories, media analysis and interviews with SMCR members with expertise in this area. I’ll include opinion pieces based on my 25 years experience as a pro-choice sexual and reproductive health advocate.

If coming off the pill is a growing trend, then may it be accompanied by a renaissance in women’s understanding of their menstrual cycles.





Does the Pill cause prostate cancer?

November 16th, 2011 by Laura Wershler

Of the growing list of reasons why women might want to reconsider using birth control pills, this could well be the strangest.

Researchers at Princess Margaret Hospital in Toronto published a study on Nov. 15  in the BMJ Open Journal in which they found a “strong correlation” between the use of birth control pills and the incidence of prostate cancer worldwide.

One of the possible explanations of how the two are related is the potential impact of the estrogen compound – ethinyloestradiol – that women using the pill secrete in their urine. It has been speculated elsewhere that these endocrine-disrupting substances could end up in our drinking water or get into the food chain.

The Pill, introduced in the 60’s, has been widely used for decades. The study suggests that exposure to these substances over 20 to 30 years could have a clinically significant effect. Researchers said further study of this link is needed.

In 2010 the media was full of stories marking the 50th anniversary of the birth control pill. The Pill at 50: Sex, Freedom and Paradox, rang the headline of a Time Magazine article by Nancy Gibbs. Could rising rates of prostate cancer be part of this paradox?

New versions of menstrual suppression drugs on the way?

August 4th, 2011 by Elizabeth Kissling

Successful tests on rhesus monkeys are a long way from clinical trials on women, but this is interesting to those of us following the conversations and debates about cycle-stopping contraceptives: new research testing progestin antagonists indicates that the drug can be successful in suppressing menstruation without necessarily suppressing ovulation. Another variant of the drug can suppress both menstruation and ovulation.

Dr. Robert Brenner, who is the lead researcher conducting these studies in the Division of Reproductive Sciences at Oregon Regional Primate Research Center, notes that this has potential beyond just a new lifestyle drug:

I would emphasize that we are not talking here only about lifestyle choices but also about the potential to bring relief to the many women who suffer years of misery from distressing complaints such as endometriosis, and painful and excessive monthly bleeding. In fact, excessive bleeding is one of the major reasons that women undergo hysterectomy, and this treatment may also reduce the need for this surgical procedure, with all its attendant risks and costs.

Block that Bloody Metaphor

September 14th, 2010 by David Linton

The challenge that advertisers face when promoting the sale of menstrual products is how to visually demonstrate how the product works or the aspects of the cycle that product addresses without showing actual menstrual blood or a woman’s anatomy. One well established solution is the use of blue liquid to demonstrate absorbency or the ubiquitous white clothing every menstruating woman is thought to prefer.

Creative metaphors and symbols abound.

Recently, a TV ad and associated web site have appeared marketing a product to treat what is called (in Capital Letters) “Heavy Menstrual Bleeding (HMB).” The web site states, “Heavy Menstrual Bleeding (HMB) is a medical condition also known as Menorrhagia.” Perhaps it would be more accurate to say, “Menorrhagia is a medical condition also known as heavy medical bleeding,” but maybe that’s just being picky.

The home page of the site claims that “Millions of women don’t have normal periods. Their periods are too heavy. But how much is too much?” The last sentence is printed in large type in a bright menstrual red color. Later, citing the US census, the site claims that there may be as many as 22 million women in the US who “suffer” from HMB, leaving unanswered how they define “normal,” a statistical term, if such a large number of women have the condition.

Since the ads and the site are the creation of a drug company, Ferring Pharmaceuticals, and the advice given is the usual “speak to your doctor” if you have these conditions, obviously there is a financial interest involved. Nothing new there. But it is fascinating to see how women’s bodies and their menstrual flow are visually constructed.

In this case, women are likened to a variety of drinking glasses containing some clear water. There are tall, slender glasses, short, round glasses, wine glasses with stems, glasses that bulge in the middle, glasses that flare out at the top. Each glass (there are nine different ones on the home page) has a different level of water in it, one only a quarter full, another three quarters, another half full, etc. We are to understand that this represents the wide variety in women’s bodies as well as the variations in the amount of menstrual blood each one produces each month.

I suppose that still water at a high level in a clear glass is an effective metaphor for a menstruating body, but when they did the video version of the promotion, they got carried away. The first image is of at lest three dozen different glasses with the suggestion of many more off to both sides of the frame. Then, as gentle music plays and a soft woman’s voice tells about HMB and that it can be treated, we see a number of glasses with low water levels. The narrator tells us that, “Every month millions of women have perfectly normal periods,” as the camera pans glasses with small amounts of water, but then, as we learn that “millions of other women don’t have normal periods,” we see a variety of glasses sinking into water or running over with water dripping down the lip or whirling through the air in slow motion as their contents spew across the frame in large and small blobs and droplets. The women represented by these glasses are in trouble and while a large glass tumbles out of control, its contents spewing every which way, the phone number and web site info settle on the screen.

I suppose it’s a good thing they used clear water. Had it been red it would have resembled a horror movie. But maybe that’s what was actually intended.

Ghostwritten articles funded by Wyeth overstated benefits and downplayed harms

September 8th, 2010 by Chris Hitchcock

An open-access article published in PLOS Medicine yesterday, Dr. Adriane Fugh-Berman, associate professor in the Department of Physiology at Georgetown University Medical Center in Washington DC, presents an article describing the ways in which the pharmaceutical industry used a medical education & communication company to produce ghostwritten articles that inserted marketing messages into articles published in medical journals.

This article is the first academic analysis of the 1500 documents unsealed in recent litigation against the pharmaceutical giant Wyeth (now part of Pfizer). It reveals the ways in which pharmaceutical companies use ghostwriters to insert marketing messages into articles published in medical journals. Dr. Adriane Fugh-Berman, associate professor in the Department of Physiology at Georgetown University Medical Center in Washington DC, analyzed dozens of ghostwritten reviews and commentaries published in medical journals and journal supplements that were used to promote unproven benefits and downplay harms of Prempro—a brand of menopausal hormone therapy (HT)—and to cast competing therapies in a negative light. These articles were widely circulated to drug reps and doctors to disseminate the company’s marketing messages. The analysis appears in this week’s PLoS Medicine.

Wyeth used a medical education & communication company, DesignWrite, to produce ghostwritten articles in order to mitigate the perceived risks of breast cancer associated with HT, to defend the unsupported cardiovascular ‘‘benefits’’ of HT, and to promote off-label, unproven uses of HT such as the prevention of dementia, Parkinson’s disease, vision problems, and wrinkles, writes Fugh-Berman.

The analysis revealed that DesignWrite was paid US$25,000 to ghostwrite articles reporting clinical trials, including four manuscripts on the HOPE trials of low-dose Prempro. DesignWrite was also assigned to write 20 review articles about the drug, for which they were paid US$20,000 each.

The analysis concludes that “Given the growing evidence that ghostwriting has been used to promote HT and other highly promoted drugs, the medical profession must take steps to ensure that prescribers renounce participation in ghostwriting, and to ensure that unscrupulous relationships between industry and academia are avoided rather than courted.”

In July 2009, PLoS Medicine, represented by the public interest law firm Public Justice, and The New York Times acted as intervenors in litigation against menopausal hormone manufacturers by 14,000 plaintiffs whose claims related to the development of breast cancer while taking the hormone therapy Prempro (conjugated equine estrogens). This resulted in a US federal court decision to release approximately 1500 documents to the public. The Wyeth Ghostwriting Archive is available at or through the UCSF Drug Information Document Archive at

Funding: The author received no specific funding for this article.

Competing Interests: Dr. Fugh-Berman was a paid expert witness on behalf of plaintiffs in the litigation referred to in this paper. She was not paid for any part of researching or writing this paper. Dr. Fugh-Berman directs PharmedOut, a Georgetown University-based project founded with public money from the Attorney General Consumer and Prescriber Grant program and currently supported by individual donations.

Citation: Fugh-Berman AJ (2010) The Haunting of Medical Journals: How Ghostwriting Sold ‘‘HRT’’. PLoS Med 7(9): e1000335. doi:10.1371/journal.pmed.1000335

(This blog largely lifted from the article press-release).

How the Pill Gave Birth to the Women’s Health Movement

May 25th, 2010 by Elizabeth Kissling
Photo from  // CC BY 2.0

Photo from // CC BY 2.0

Only a latter-day Rip Van Winkle could avoid knowing that this month marks the 50th anniversary of the FDA’s approval of Enovid, the world’s first birth control pill. Hundreds of newspaper and magazine articles have marked this anniversary.

Many incorrectly credit the pill with giving birth to feminism. As Elaine Tyler May notes in the current issue of Ms., the pill didn’t start the feminist movement but was in the right place at the right time:

The timing could not have been better. The feminist movement gained momentum just as the Pill became available. With the ability to control their fertility, women could take full advantage of new opportunities for education, careers and participation in public life.

But in the midst of all this celebrating, we’ve neglected another anniversary: 2010 marks the 40th anniversary of U.S.  Senator Gaylord Nelson’s congressional hearings about the pill’s safety profile, which arguably did launch the women’s health movement.

That launch received a giant shove from Barbara Seaman, a magazine writer who published a book called The Doctor’s Case Against the Pill in 1969, and Alice Wolfson, a then-student and feminist activist. Seaman’s book documented medical risks of the pill–such as blood clots, decreased sex drive, mood disorders and certain cancers, and she alleged that the pharmaceutical industry had suppressed such information. Sen. Nelson was investigating other allegations against the pharmaceutical industry and read Seaman’s book, which motivated him to take on the pill as well.

At the time of the hearings, Wolfson was part of an activist collective known as D.C. Women’s Liberation. In discussing whether or not to attend the hearings, Wolfson and several other members discovered they all had experienced negative side effects of the pill, which their physicians had not warned them about. That revelation led to something bigger. As Wolfson later wrote in her memoir, “We went to the Hill to get information. We left having started a social movement.”

At the Nelson pill hearings, as they soon became known, medical experts delivered testimony about the known risks of synthetic estrogen, one of the main ingredients in birth control pills. No pill users were on the agenda. The only woman who testified was Dr. Elizabeth Connell, who expressed the fear that if dangers of the pill were publicized, women would give up birth control entirely. Connell said she worried that would lead to an explosion of unwanted pregnancies, or “Nelson babies.”

Alice Wolfson says she doesn’t remember the exact tipping point in the hearings that prompted her to speak up, but I like to think it was the moment when a medical researcher testified, “Estrogen is to cancer what fertilizer is to wheat.” Wolfson and other women raised their hands politely to comment, but when Sen. Gaylord refused to recognize them, they began shouting their questions.

Why weren’t we told about side effects?

Why aren’t any women testifying?

What happened to the women in the Puerto Rico study?

Why are you using women as guinea pigs?

Why are you letting the drug companies murder us for their profit and convenience?

The feminists immediately had the attention of reporters, and a movement was born. Seaman and Wolfson met during one of the breaks in testimony, and eventually worked together to create the National Women’s Health Network – still a vibrant and vital advocacy organization for women’s health.

The Nelson pill hearings eventually led to lower doses of estrogen in the pill (today’s oral contraceptives are about 1/10th the strength of Enovid) and perhaps more importantly, the introduction of patient package inserts, PPIs. The new FDA requirements resulted in the inclusion of printed information about risks, ingredients and side effects in pill packets, and eventually in all pharmaceuticals.

Women’s health activists went on to work for tampon safety regulations in the 1980s, resulting in an FDA mandate for consistency of absorbency ratings and warnings regarding tampon-associated Toxic Shock Syndrome (TSS); withdrawal of fen-Phen diet pills in the 1990s; ongoing revisions of the ACOG guidelines for VBAC (vaginal birth after cesarean) and so many other issues in support of women’s health, safety and well-being.

Cross-posted at Ms. magazine blog.

“Why I’ll never take the pill again”

May 11th, 2010 by Chris Hitchcock

In an article in today’s Independent, Holly Grigg-Spall presents an alternative to the current celebrations of the pill. It’s an important message to add to the collective contemplation of what the pill has meant to women and to women’s lives, and interesting reading. The pill prevents pregnancy, but not everyone likes how they feel when they take it, and women’s experiences are often not heard or dismissed. In a world where proponents of the pill see it as a cure for all things menstrual, and recommend it as therapy for the painful cramping that the majority of teenagers experience, it is important to also say that there are significant side effects for some women that affect quality of life.

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.