Birth control pills and IUDs – cause and maintaining cause

Sometimes it’s a question of finding reasons, not giving remedies.

 

A patient came to me recently suffering from anal fissure, hemorrhoids and constipation.  In that order – the fissure began several years previously, then the hemorrhoids appeared, and in recent months she began suffering from constipation.  In itself this progression looks odd, as usually we’d expect the constipation to come first.  But then the patient reported that she was completely clear from symptoms during pregnancy and immediately after giving birth. And then the nightmare began again.  Curiouser and curiouser, to borrow an expression.

Homoeopathy was seen as a last resort before surgery, which seemed at this stage fairly inevitable, as far as the patient was concerned.

The anal fissure began shortly before the patient married.  There was no history whatsoever of such problems beforehand.  An examination of what changed at that time led to a possible culprit: birth control pills taken to regulate the period.

It is important to note here that many women will take birth control pills just before marriage to regulate a period even if they are not yet sexually active, to make sure that the special day is not ruined by an unwelcome arrival of menses.  In some cultures it is almost religiously mandated.

Back to the plot.  A search of the side effects of the contraceptive for anal fissure came up with nothing.  But a search giving the name of the contraceptive + “anal fissure” opened up a mother lode of discussions among women, asking whether it’s at all possible that their anal fissures are due to this particular contraceptive.  The extent of the informal reporting of problems even resulted in a scientific report noting these complaints and stating a connection.

A similar search relating to a second contraceptive in this case with the most recent symptoms reported by the patient, together with an odd skin symptom that she had reported, brought up a similar torrent of discussion among women who were comparing their symptoms, getting no satisfactory responses from their doctors, and turning to other women for some validation of their complaints.

I suggested to the patient that she stops the contraceptives, to see if the symptoms would ease.  She reported a significant improvement within two weeks of stopping, and the improvement has continued.

Many, if not most of the women we treat are on some form of hormonal birth control, whether in the form of pills or an IUD.  Because of this case, I looked at an older case of a woman who had been complaining of itching for 10-15 years, with no rash or visible symptoms on the skin.  She tried treatment for a short time, but without significant improvement.  When I examined the notes, I saw that the timing of the itching roughly corresponded with the insertion of a contraceptive IUD.  A search with the name of the contraceptive and the complaint again brought up a wealth of discussions on the internet, enough for me to suggest that the patient look into it.  She seemed doubtful.  After all, her gynecologist had never made the connection.

There are two central issues to be learned here.

Firstly, hormonal contraceptives taken by women are such an insidious part of modern life that there is a tendency to overlook the possibility that they are causing symptoms, and that they may even be the sole cause of a symptom picture.  And I’m sure there are some out there who say “of course women are complaining on the internet, they complain about everything.”  It’s time to put this kind of rubbish aside, to look at the many complaints regarding birth control pills and IUDs and to find viable alternatives which will not put the women at risk, which is so patently the case nowadays.  The complaints I’ve reported here are the least dangerous of potential issues, but they are an early warning sign, and most definitely the thin end of the wedge / tip of the iceberg / canary in the mine.  This is especially true in cultures where condoms are forbidden, putting women in extremely difficult if not impossible situations where family life is concerned.

But there is a second issue regarding anecdotal evidence.  When one person after another complains about the gear or brakes of a particular car, it doesn’t take a scientific study to know that it’s worthwhile looking into the matter carefully before buying that car.  Logic dictates that the same should be  true where one person after another chimes in on an internet forum complaining of side effects from conventional medicines – even if those side effects are not (yet…) listed in the formal literature.

 

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