Hormonally Active Contraceptives, Part II: Sociological, Environmental, and  Economic Impact

William V Williams; Joel Brind; Laura Haynes; Michael D Manhart; Hanna Klaus; Angela Lanfranchi; Gerard Migeon; Michael Gaskins; Elvis I Šeman; Lester Ruppersberger; Kathleen M Raviele

doi:10.1177/00243639211005121

Hormonally Active Contraceptives, Part II: Sociological, Environmental, and Economic Impact

Williams WV, Brind J, Haynes L, Manhart MD, Klaus H, Lanfranchi A, Migeon G, Gaskins M, Šeman EI, Ruppersberger L, Raviele KM

Published August 2021 The Linacre Quarterly, 88(3), 291-316

DOI 10.1177/00243639211005121 PMID 34565905 PMC PMC8375383

RRM Academy Synopsis

Hormonal contraceptives carry social and economic costs, review argues

Hormonal contraceptives carry social, ecological and economic costs, a 2021 review argues. The authors read published studies. They used known risks to estimate extra disease cases and costs in the US.

Key Findings

The authors cite a national survey in which women with no intercourse by age nineteen fell from 45 percent in the 1950s and 1960s to 17 percent in the 1970s and 1980s.
The authors report that the share of pregnancies ending in induced abortion was essentially zero from 1935 to 1965, and has ranged from 16 to 30 percent since 1975.
In a seven-year Canadian lake study, added synthetic estrogen equal to the sewage of a city of 200,000 people brought fathead minnows to near extinction. They rebounded after the additions stopped.
Applying a relative risk of 1.19 (95 percent CI 1.14 to 1.26) for combined oral contraceptives to 3,577,264 US breast cancer cases, the authors estimate 452,930 excess cases, about US$10 billion yearly.
The authors also estimate lower disease with combined oral contraceptives, including 31,487 fewer ovarian cancer cases and annual savings of US$820,419,141.

Interpretation

This review models costs from published risk estimates for combined oral contraceptives. The sociological sections set time trends side by side. They cite authors who tie those trends to contraception. The authors note that a link between environmental estrogen and human health is possible but not yet proven. The findings support larger studies of these social, ecological and economic costs.

RRM Context

The authors close with a case for fertility awareness-based methods: the Billings Ovulation Method, the sympto-thermal method and the Creighton Model System. They call these methods similar to the combined oral contraceptive pill at avoiding pregnancy, citing two sources. Restorative reproductive medicine works with the ovulatory cycle. Cycle charting is the shared basis of these methods. Part one of this series describes the medical effects behind the risk figures.

Our editorial summary of this paper, not the article's abstract.

Abstract

To investigate the sociological, environmental, and economic impact of hormonally active contraceptives, a series of comprehensive literature surveys were employed. Sociological effects are discussed including abortion, exploitation of women, a weakening of marriage, and an increase in divorce with deleterious effects on children such as child poverty, poorer health, lower educational achievement, suicide risks, drug and alcohol abuse, criminality, and incarceration, among others. The environmental impact is discussed briefly and includes the feminization and trans-gendering of male fish downstream from the effluent of city wastewater treatment plants with declining fish populations. The potential economic impact of most of these side effects is estimated based on epidemiologic data and published estimates of costs of caring for the diseases which are linked to the use of hormonally active contraceptives. Hormonally active contraceptives appear to have a deleterious impact on multiple aspects of women's health as well as negative economic and environmental impacts. These risks can be avoided through the use of nonhormonal methods and need to be more clearly conveyed to the public.

Summary

Hormonal contraceptives have wide-ranging effects. The potential economic impact of the medical side effects is estimated. Sociological effects are discussed including abortion, exploitation of women, a weakening of marriage and an increase in divorce with negative effects on children such as child poverty, poorer health, lower educational achievement, suicide risks, drug and alcohol abuse, criminality and incarceration among others. The environmental impact includes hormonal effects on fish with declining fish populations. Women seeking birth control have a right to know about how to avoid these risks by using effective hormone-free methods like Fertility Awareness Methods.

Topics

Contraception Adverse Effects Mood and Libido

Contraception › Adverse Effects › Mood and Libido

William V Williams, Joel Brind, Laura Haynes, Michael D Manhart, Hanna Klaus, Angela Lanfranchi, Gerard Migeon, Michael Gaskins, Elvis I Šeman, Lester Ruppersberger, Kathleen M Raviele

Bill Williams, Will Williams, Billy Williams, W Williams, J Brind, L Haynes, Mike Manhart, M Manhart, H Klaus, A Lanfranchi, G Migeon, Mike Gaskins, M Gaskins, E Šeman, L Ruppersberger, K Raviele

PMID 34565905 34565905 DOI 10.1177/00243639211005121 10.1177/00243639211005121 Williams et al. 2021, Williams 2021