Sweetening the Pill – has contraception liberated or oppressed women?

Holly Grigg-Spall

Holly Grigg-SpallAs part of this month’s focus on sexual health we spoke to author Holly Grigg-Spall about her forthcoming book, Sweetening the Pill, which explores the impact of hormonal contraception on our health and wellbeing. Here’s what she has to say on the subject…

It was loss of libido that first made me consider that the myriad physical and mental health issues I had been experiencing for some time might be down to the birth control pill I was taking – Yasmin. It was this well-known side effect of the pills I had taken for ten years that set me on the path to investigate in what other ways hormonal birth control might be impacting my experiences. The research became the basis for my blog, and subsequent book, the forthcoming ‘Sweetening the Pill or How We Got Hooked on Hormonal Birth Control’. What follows here is an excerpt from that book.

Leonore Tiefer is Clinical Associate Professor of Psychiatry at the New York University School of Medicine and Albert Einstein College of Medicine. She has written widely about the medicalization of female sexuality and heads up the New View Campaign, which is a grassroots network challenging the distorted and oversimplified understanding of sexuality promoted by the pharmaceutical industry as a means to profit.

She is particularly involved in criticism of the race to produce a ‘female Viagra.’ The female Viagra patch Intrinsa was rejected by the FDA in 2004, not due on potential side effects but due on questions as to its results. Tiefer remarks on this, “For Intrinsa, and for Viagra, the placebo has shown to be extremely effective in clinical trials. The placebo provides a forty percent improvement. The drug itself showed an improvement higher than this, but not significantly. The pharmaceutical companies do not make direct comparison, because, as they say, they’re not marketing the placebo.”

The drug Flibanserin was in research until 2010. The aim was to treat women who lack libido and sexual desire. It was set up in opposition to hormonal birth control methods with their negative impact on libido. Dr Irwin Goldstein is very vocal about the negative effect of hormonal contraceptives on sexual desire. He has discussed openly the emotional and mental side effects of hormonal birth control. He’s conducted studies to show that women are less interested in sex when on the pill. Yet he labels these issues as a dysfunction called “hypoactive sexual desire disorder” and is a strong supporter and bank rolled associate of the pharmaceutical company behind Flibanserin.

Goldstein has gone as far as to state that this drug would provoke “the beginning of an era for women,” and that releasing it on the market would be a “unique and historic opportunity for women in the US and for the FDA.” Research was halted when studies discovered it had very little impact beyond that of the comparative placebo pills. It also produced, of course, a myriad of side effects.

The documentary Orgasm Inc explores the pharmaceutical industry’s involvement in developing disorders that can be responded to with the creation of a pill. The potential markers of disorders are widened to provide a broad spectrum of potential customers for a new drug. Just as hormonal contraceptives are now readily prescribed for an extensive list of health problems, a pill for sexual dysfunction will demand the creation of problems where there are only healthy variations on normal biological functions.

Orgasm Inc followed a middle-aged woman who became  involved in the research testing of a female Viagra-type drug because she didn’t realize that not being able to orgasm through penetration alone was not “abnormal.” She assumed the drug was created to address this “problem.” As the New View Campaign outlines in its manifesto – it has become a requirement that a woman have sexual responses “like a man.” The efforts to produce drugs are rooted in a standard that sets male sexuality as the norm, as a state to which women must aspire. The convenient, non-obstructive hormonal methods of birth control are means to allowing women to have sex “like a man.”

The impact of hormonal contraceptives on many women has been exploited by the pharmaceutical industry. Instead of this issue causing us to question why we are happy for women to take a pill to have supposedly worry-free sex that denigrates their enjoyment of the act, we have a new range of medically defined disorders for the DSM that instigate a new pill to solve the problems.

In 2009 Bayer announced it would be working on drugs to treat “symptoms” of menopause and other “gynecological disorders.” Such disorders are defined as pelvic pain, vulvodynia and vaginitis. Vulvodynia is often experienced as pain during sex. Vaginitis is irritation or pain within the vagina.

A decrease in libido is just one of the pill’s direct impacts on women’s sexual desire and enjoyment. Hormonal birth control can thin the vaginal walls and cause tearing. There can be a decrease in natural lubrication and a decrease in the ability to orgasm. Dr. Andrew Goldstein, director of the US-based Centers for Vulvovaginal Disorders and one of the foremost vulvodynia experts in North America blames an increase in complaints of this kind on lower dose, new generation pills. Dr Goldstein has suggested women consider the cause of these issues is their hormonal contraceptive or any other hormone-based treatment they’ve been receiving before they take another action to alleviate the symptoms.

Often pain during sex and other “gynecological disorders” are diagnosed as the result of psychological issues with sexual contact, as the symptom of an STI or the product of “rough” sexual encounters. Those women who experience these problems and are not on hormonal contraceptives are often prescribed the birth control pill as the treatment in another example of its status as a “cure-all” drug.

We’d love to hear your feedback and experiences – positive and negative – of hormonal contraceptives. Email nicci@rudemagazine.co.uk.

Sweetening the Pill or How We Got Hooked on Hormonal Birth Control is published by Zero Books, £12.99 on 27th September. Order your copy here.


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