New documentary examines ‘the pill’

April 8, 2022 – Birth control pills have long been known to have a checkered history.

Before the era of informed consent in clinical trials, hormonal contraceptives were tested in vulnerable populations.

The warning labels for blood clots and heart attack risk were not added to the package inserts until 1978. The hormone-releasing NuvaRing birth control method has been linked to pulmonary embolism (blood clots in pulmonary arteries), leading to thousands of lawsuits against Merck.

Still, its use is widespread: 12 million women are currently taking the Pill and 80% of women have ever used the Pill to prevent pregnancy, regulate their periods or treat their acne.

In The Business of Birth Control, a documentary out this week digitally and in theaters, the filmmakers argue that while hormonal contraception was considered a huge step toward women’s reproductive freedom when doctors started it 60 years ago, writing, it is also not without its risks, which may be why more and more women are seeking holistic and ecological alternatives to the Pill.

“This film questions assumptions,” says Jacques Moritz, MD, an OB/GYN and medical director of Tia Clinic, a women’s health practice in New York City featured in the film. “There’s a paradigm shift going on right now, where women are more empowered about their birth control options instead of just getting a prescription and being told to take it and you’ll be fine.”

WebMD spoke with Moritz about the film, side effects of hormonal birth control, and how younger women have been looking for new birth control options. The following interview has been lightly edited for length and clarity.

WebMD: The film goes into quite some depth about the psychological effects of hormonal birth control, such as depression and mood swings.

Moritz: There is an awareness as women are talking to each other about the neurological or neuropsychological changes that the pill can bring about. Many people on the pill experience depressive events and had no idea that it could mess up your head. Therefore, more mental health studies are needed on the effects of combination birth control pills. There haven’t been many.

WebMD: Have you noticed that younger women are changing their minds about hormonal birth control?
Moritz: When you’re on the pill, the body thinks you’re pregnant and you don’t ovulate, so you have all the symptoms of pregnancy. The side effects of the pill are exactly the same whether it be weight gain, depression, fluid retention or moodiness.

This hasn’t been talked about much, but yes, there’s been a renaissance among our younger patients who don’t want to use hormonal birth control pills.

WebMD: What are the pros and cons of taking the pill?

Moritz: We know that the risk of heart attacks and strokes triples — and smoking makes it worse — when you’re on the pill.

On the other hand, we know that the pill reduces the risk of ovarian cancer, has a miraculous effect on polycystic ovary syndrome, which affects 1 in 10 women, reduces painful periods and prevents pregnancy, which is a major problem.

While there are a few studies showing more depressive events in those who use it, we lack sufficient studies on the mental health aspects of its use. In addition, there are some studies on libido, and that’s a double-edged sword: your libido rises if you’re not worried about getting pregnant, but can drop if the pill lowers testosterone, making you uninterested in sex. It goes both ways.

WebMD: What are the best options for women who want to use non-hormonal birth control?

Moritz: This depends on where they are in their relationship. If you need 100% birth control, there is only one option: the copper IUD, which has a 0.2% failure rate. But there is also a downside in that these lead to heavier and more painful periods.

If you are in a relationship and planning to have children but you don’t want to get pregnant right away I would say you can try the withdrawal method, diaphragms, the cervix cap and natural planning using the calendar method but it is limited to those who menstruate regularly, and there is a pretty high failure rate with these methods.

WebMD: What do you want women to think about when they consider filling a birth control prescription?

Moritz: I want women to look at all the options available, understand the pill’s mechanism of action, and understand that this is a bit of body cheating and that there can be side effects.

The pill is relatively safe if you don’t have any medical conditions, if you don’t smoke or drink, or if you don’t have a family history of blood clots, which is hard to say. On the positive side, the pill has been used for a long time and the dosage has dropped drastically. Today’s Pill is not your mother’s – or your grandmother’s.

This post New documentary examines ‘the pill’

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