OT - Too good to be true?

[Guest guest]

I particularly like this quote: " All medicines are just useful poisons " .

I would question the use of the word " useful " . ) And I cannot begin to

wonder how this would screw up a woman's body. (

Sue

http://www.guardian.co.uk/medicine/story/0,,1742700,00.html

Too good to be true?

This week scientists claimed to be developing a drug that prevents pregnancy

and stops PMT. Where's the catch, asks Polly Curtis - and what's wrong with

the current pill anyway?

Thursday March 30, 2006

The Guardian

Fifty years ago, the first major trials of an oral contraceptive produced a

pill that gave women control over their fertility for the first time. This

week the next big leap for womankind was heralded with the reporting of

trials of the first major new pill to provide protection against pregnancy -

without scary side-effects. The new generation of the pill, should it live

up to the scientists' hopes and justify the " Super pill " and " Wonder drug "

headlines, will control women's fertility while reducing the major risks of

breast cancer, thrombosis and heart disease associated with the current

pill. All this as well as stopping periods, potentially freeing women of

PMT.

There was much excitement but also increasingly desperate notes of caution

from those in the frontline of family planning. " We would be disappointed if

this new pill made people think the current pill is unsafe, " says Toni

Bellfield, director of information at FPA, formerly the Family Planning

Association.

The worries about the existing pill - combined, mini or otherwise - are

already enough to make many women feel they should not take any oral

contraceptive for too long. So when they hear about the so-called " dream

pill " the verdict is predictable: It sounds fantastic ... what's the catch?

The first is that scientists believe it will be at least another five

years - and probably more like 10 -before it's on the market. And who is to

say the product will live up to the hype? The current hoo-ha is based on

trials of fewer than 200 women. It's a small sample and more detailed

studies may have an altogether gloomier outcome.

The second is FPA's question: what's wrong with the existing pill? Should

women, for example, be worried about the breast cancer link? Studies show

that breast cancer rates increase by 24% among women who have been taking an

oral contraceptive in the past 10 years - though the heightened risk is

thought to disappear 10 years after a woman stops taking the pill.

Glasier, director of sexual and reproductive health at the University

of Edinburgh, says the figures can be misleading. " Women who are on the pill

are younger, and therefore at very slight risks of these illnesses to begin

with. An increase of 24% in breast cancer does not amount to huge numbers of

women. "

So for every 10,000 women who take the pill for five years, an extra one or

two cases of breast cancer will be diagnosed in those who stop at 25, four

to five in those who stop at 30 and an extra 11 in those who stop at 35.

The risk of thrombosis ( blood-clotting) is about 300% higher among women

who are on the pill compared with those who aren't. " Yes, the risk of

thrombosis is three times higher, but if you're pregnant it's six times

higher and what you're trying to avoid when you're on the pill is getting

pregnant, " says Glasier. " It's safer to be on the pill than pregnant. "

The women who might be worried about this - those who are overweight, smoke

or have a history or diagnosis of high blood pressure - might benefit from

the new drug, but are already offered the progestogen-only pill, which

reduces those risks.

Osteoporosis has been linked to the injected hormonal contraceptive

Depo-Provera. But most studies suggest the oestrogen in the pill actually

provides some protection against bone thinning, something the new pill does

not seem to offer. The protection the current pill gives against cancers of

the womb, ovaries and perhaps now the bowel are also proven - but not in the

new pill.

As for the excitement over the prospect of doing away with menstruation?

It's not actually a terribly new idea. The current pill requires a seven-day

break once a month when bleeding - though not a full period - occurs, but

can already be safely taken without that break, something many women opt to

do at their convenience (a so-called period holiday). Many women who opt for

Depo-Provera stop menstruating altogether, for up to 18 months after their

final injection wears off. A new pill being sold in the US is Seasonale,

which is taken for 84 days straight with a break four times a year for your

seasonal period: the spring, summer, autumn and winter bleeds.

What the new contraceptive may be able to do is reduce the slight risk from

the old pill of breast cancer, thrombosis and heart disease and suspend

periods. There is also no sporadic bleeding, which can occur with the

progestogen-only pill. But what else it does, what new side- effects it

might bring further along the line, have not been investigated.

Perhaps the real struggle with the pill 50 years on is not so much about its

potentially deadly side-effects, but its day-to-day impact on women's lives.

Alice , a 27-year-old social worker from Bristol, has chopped and

changed her pill over the years according to her relationship status but

also how they made her feel. Her worry isn't necessarily about breast cancer

or heart disease, but her moods, her libido and how it affects her weight.

" I came off it and lost half a stone in two weeks. Libido definitely goes

down. Doctors will let you change if it gives you headaches, but you're not

encouraged to if you're not obese but worried about weight. I'd prefer to be

on the pill the whole time, but only if it didn't have all these effects. "

The problem is that every pill has a slightly different effect on individual

women's hormones, and hormones, bundled up as they are in emotions and

moods, react differently from person to person. Every drug has side-effects,

so perhaps the idea of a problem-free pill is a wild goose chase.

Kay Wellings, professor of sexual and reproductive health research at the

London School of Hygiene and Tropical Medicine, says the decisions women

make about contraception are an incredibly complex trade-off between risks

and benefits.

" If you're hellbent on not getting pregnant you'll put up with the odd

headache, or a couple of pounds gained in weight won't mean much to you. You

weigh up the pros and cons, as you do with every medicine. All medicines are

just useful poisons. "