Overload

Contraceptives

Category: Medicines

Type

Involuntary and voluntary

Introduction and description

Contraceptive medicines are a form of birth control.

Birth control as a whole includes a whole range of different methods, chemicals, plants and devices whose only aim is to prevent pregnancy.

This section covers only pharmaceuticals and if we were being strict about definitions they should not really be called a ‘medicine’ as their aim is neither to alleviate symptoms or heal, but this was a convenient place to slot them.

Thus this page does not cover sterilisation, vasectomy, intrauterine devices, condoms, diaphragms, contraceptive sponges, or spermicides. But it does cover implantable contraceptives that use drugs, oral pills, patches, vaginal rings if they are impregnated with chemicals and injections.

It is one of the sadder aspects of this area that practically all these drugs have to be taken by the woman. One of the safer methods is actually a condom, as it both provides good birth control, but also protects both partners from sexually transmitted diseases, a not insignificant factor given that it was found that around 98% of people in one study in the USA were found to have herpes on death. In fact it may have been the herpes that killed some of them.

The drugs

The progestogens, androgens, and estrogens are the three major classes of steroid hormones related to sexual function. Synthetic progestogens are generally referred to as Progestins. Contraceptives for women manipulate the estrogen and progesterone. Two types of female oral contraceptive pill, taken once per day, are widely available:

The combined oral contraceptive pill contains estrogen and progestin
The progestin-only pill

Emergency contraception pills ("morning after pills") are taken at the time of intercourse, or within a few days afterwards.

Many of the oral contraception pills are based on various forms of estradiol which is a close relative of estrogen. Taken daily in pill form the estradiol prevents ovulation (the release of an egg from an ovary) and also causes changes in your cervical and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

The hormones in combination and progestogen-only pills also tend to thin the lining of the uterus. This could prevent pregnancy by interfering with implantation of a blastocyst.

Background

The Combined oral contraceptive pill (COCP), often referred to colloquially as "the pill", was first approved for contraceptive use in the United States in 1960.

They are currently used by more than 100 million women worldwide and by almost 12 million women in the United States. Use varies widely by country, age, education, and marital status. One third of women aged 16–49 in the United Kingdom currently use either the combined pill or a progestogen-only "minipill", compared to only 1% of women in Japan.

Sexually transmitted diseases and their prevalence - WHO

According to Wikipedia.................................................

The Pill was a catalyst for the sexual revolution.

World historians credit the Pill as the most important contraceptive to transfer power about reproductive rights from men to women!

Or if we rephrase this, to transfer the responsibility for both birth control and sexually transmitted diseases from men to women.

In June 2016, eHealthme ceased to provide the information on which all the data in this section is based. On querying my friends in the USA, it would seem that many of the sites that provided similar information, have done the same. The links we provided to eHealthme also no longer work as this data too has been removed.

As to why all these sites have removed exceptionally important information, my USA helpers said that more and more people are questioning what they are being given – and demanding to know WHY the CAUSE of their illness has not been investigated. It appears that there has been a very heartening increase in the numbers of people who want to be healed – have the cause tackled and not the symptoms. And this is ‘not popular’ with the conventional medical community, who cannot make money from well people.

The statistics collected from eHealthme remain valid for the date they were collected. As such we have left this section as it is – an historical record. Please read this section therefore only as an historical record of the figures that were applicable on the date specified.

Side effects

The claim is that the pills are safe and indeed very very few hallucinations are caused by them, as you will be able to see from the chart below. But these pills are not without their problems.

Menopausal problems

Contraceptive pills disrupt the normal cycles of a woman and there does appear to be a link between a life spent taking estrogen and appalling menopausal symptoms. The woman is left at the end of her child bearing life with ovaries still full of unused eggs and the body goes haywire attempting to rid itself of them, turning the poor woman from manic to depressive by the hour, with one moment a sexual appetite matched only by the Greek nymphs and at the next stage an aversion to men that can be life threatening for the man!

Fibroids

Equally serious are the changes to the uterine lining. There are links with the formation of fibroids in later life and other problems related to the uterus.

A woman on the pill will have a withdrawal bleed sometime during the placebo week [see below]. The withdrawal bleeding that occurs during the break from active pills was thought to be comforting, as a physical confirmation of not being pregnant. The 28-day pill package also simulates the average menstrual cycle, though the hormonal events during a pill cycle are significantly different from those of a normal ovulatory menstrual cycle. The pill suppresses the normal cycle, and the withdrawal bleeding occurs while the placebo pills are taken.

A person on the pill is not menstruating.

Biological imbalance

Many many foods contain what are called phytoestrogens. We have a very detailed description in the science section on these chemicals. Very briefly, plants are able to affect our fertility too. When a plant has been grown in stressed conditions, in times of drought for example or variable weather it will produce phytoestrogens that actually affect the fertility of those animals and birds that feed on it and its seeds.

It is a clever strategy, as it ensures that in its weakened state, lacking in seed, it doesn’t get wiped out by its predators. If we eat these plants we too may have our fertility affected. Thus although we may believe that the only birth control method we are using is the pill, in reality we are using plants as well. Drink soy milk, eat lots of flax seeds, and oat cakes, enjoy a tofu sandwich and we are overdosing in a severe way on phytoestrogens, assuming the plant has produced them.

Constant disruption to our sex hormones is going to produce mood swings, irrational behaviour, and even some of the symptoms of the menopause during mid-life. Premenstrual symptoms may be a direct result of this massive swinging of the hormonal pendulum as a result of the combining of phytoestrogens and pharmaceutical estrogens.

If we also add in the fact that an additional animal source of progesterone is milk products and that after consumption of milk products the level of bioavailable progesterone goes up, you can see that the body is not in a state of balance on these drugs.

The degrading of love, the rise of lust

Very few studies appear to have looked at the contrary argument to that lauded by Wikipedia and that is that with the introduction of contraceptives, the responsibility for prevention of unwanted pregnancy and sexually transmitted disease passed completely to the woman. Most men simply took it as a signal that they no longer had to use condoms. One suspects that the very research done on the pill by men was not actually aimed at protecting women, which it clearly does not because the risk of infection escalates considerably, but at removing that barrier to male pleasure – the condom.

The sixties were a very difficult time for a great many women because of the pill. It was not a saviour or a liberator. Men started to expect women to be on it. There was a shift in thinking that moved from the romantic love that many women sought, to that of simply the temporary kick one gets from the sex act when love is not involved. From the woman’s point of view she was forced to go from the Rolls Royce of hearts, flowers and gentleness to the noisy, uncomfortable, pointless activity of an old banger.

Furthermore, from that point on men absolved themselves from all responsibility for sexually transmitted disease and unwanted pregnancy. Men who pass on HPV, for example, sail on oblivious. Women who get it suffer - either by virtue of the fact their cervix has to be removed so they can no longer have children, or they die.

we can't turn the clock back, but it might be wiser to seek a new way

The pill put a great deal of pressure on women to have sex when they didn’t want to. Many women of that generation would have preferred to have waited until they were married – a little more sure that they were being married for love and not for pleasure.

I cannot speak for the generation of today, but the girls of the 60s were brought up watching Ingrid Bergman and Humphrey Bogart in Casablanca only to be confronted with the sort of behaviour well described in Grease.

And it has been downhill ever since.

There are incidentally still men who like romance and flowers, gentleness and love, but they are pursued by so many women, you can’t see them for the rose petals.

Rape rate per 100,000 population, comparison by country, 2012 statistics taken from the United Nations

Cholesterol and the heart

All the hormones – progesterone, estrogen, and testosterone and the other androgens are made from cholesterol.

Putting this very simply, although cholesterol has a multiplicity of uses in the body besides its use in providing the raw material for the manufacture of our sex hormones, by adding progesterone to our system and then subsequently eating cholesterol rich foods on a regular basis, we are inevitably going to have an excess of cholesterol in our blood stream.

And this may indeed be one occasion when the increased cholesterol - which is not there for a purpose such as cell repair, - may indeed cause atherosclerosis.

Epidemiological studies have pointed to a correlation between the oestrogen content of oral contraceptives and the risk of deep vein thrombosis (DVT). The correlation has been strongest in studies which partially consisted of adverse drug reaction reports to the Swedish Adverse Drug Reaction Advisory Committee (SADRAC). The present study analyzes the epidemiological basis of the adverse drug reaction reports on DVT in women on oral contraceptives to SADRAC. It verifies the reported correlation between the oestrogen content of the pills and the risk of DVT. PMID: 3987273

The Adverse Drug reports submitted to the FDA and SEDA are still coming up with this same finding, DVT is a risk of the pill and those on the pill would do well to reduce their cholesterol intake.

For example, most common Nuvaring side effects:

Pulmonary Embolism in Nuvaring (3,140 reports)
Deep Venous Thrombosis in Nuvaring (2,147 reports)
Thrombosis in Nuvaring (656 reports)
Hypercoagulation in Nuvaring (610 reports)

and the most common Ortho evra side effects:

Pulmonary Embolism in Ortho evra (1,948 reports)
Deep Venous Thrombosis in Ortho evra (1,433 reports)

Cholesterol and gall stones

There are also reasons to link both HRT and contraceptives with gall stones

BACKGROUND: Chronic application of third generation progestagens as contraceptives or hormone replacement therapy (HRT) could influence the serum lipid profile, and consequently the bile and gallstone composition.
AIMS: To determinate components of serum, bile and gallstones in women of reproductive age or postmenopausal women using hormonal third generation for at least two years.
METHODS: We enrolled 101 Caucasian women with cholelithiasis. The study included 45 women of reproductive age and 56 postmenopausal women who were divided into subgroups receiving or not exogenous female hormones. In patients we determined serum levels of 17β--estradiol, triglycerides, HDL and LDL cholesterol as well as composition of gallstones and bile.
RESULTS: The postmenopausal women showed a significant reduction in the concentration of bile acids in serum while the application of HRT caused an increase in their contents. Serum total and LDL cholesterol in postmenopausal women was higher than in women without hormonal contraception and postmenopausal patients with HRT. Moreover, women taking the exogenous hormones showed a reduced content of calcium ions in both serum, bile and gallstones.
CONCLUSIONS: Our observations confirm that the chronic use of oral contraceptives and hormone replacement therapy cause an increase in bile lithogenity. PMID: 25413941

Headaches

One interesting side-effect of contraceptives seems to be an increase in headaches. In co-morbidity studies done by ehealthme, there was a high correlation between the use of contraceptives and headaches. This may be a knock on effect from the atherosclerosis.

On Oct, 10, 2015: 3,699 people who have birth control and Headache are studied.

Trend of Headache in birth control reports

Iron overload

Most brands of combined pills are packaged in one of two different packet sizes, with days marked off for a 28-day cycle. For the 21-pill packet, a pill is consumed daily for three weeks, followed by a week of no pills. For the 28-pill packet, 21 pills are taken, followed by a week of placebo pills.

The placebo pills allow the user to take a pill every day; remaining in the daily habit even during the week without hormones. Placebo pills may contain nothing that has an effect pharmaceutically, but there are some pills that contain an iron supplement.

Supplements of any mineral or vitamin can overload the body. They do little good and from the evidence do a great deal of harm sending the body completely out of balance. This section describes the effects of iron imbalance – one of which can be brain damage.

Getting pregnant on the pill

The pill requires a certain amount of discipline and also regular hours. Those who go on holiday to far off places, or who work shifts, can find it very difficult to get it right. It is too easy for many people to miss a pill, sometimes because they come home too dog tired to remember.

Some drugs reduce the effect of the Pill, but few people know this - drugs such as rifampicin, barbiturates, phenytoin and carbamazepine; and the broad spectrum antibiotics, such as ampicillin and doxycycline. St John's Wort has also been implicated due to its upregulation of the P450 system in the liver.

It is clear that some of the 'low dose' pills do not work, or at least significantly increase the risk, for example, the figures from eHealthme:

Unintended Pregnancy in Lo/ovral-28 (198 reports)
Drug Ineffective in Lo/ovral-28 (184 reports)

Add to this the problems of Irritable bowel syndrome, or diarrhoea, or the over enthusiastic use of laxatives, or nausea followed by vomiting and the pill may not work and you are pregnant.

There is also growing evidence that implants and injectables do not work. In other words, those who are given implants so that they don't have to remember to take the pill, appear to be getting pregnant more frequently for example, these figures come from eHealthme:

Pregnancy With Implant Contraceptive in Implanon (450 reports)
Drug Exposure During Pregnancy in Implanon (274 reports)
Abortion Spontaneous in Implanon (269 reports)
Unintended Pregnancy in Depo-provera (932 reports) - and for those who doubt DepoProvera has been prescribed as a contraceptive, the ehealthme site recent statistics say that in February 2016 Depo-provera for Birth Control was reported by 428people [the other people who became preganant were using it for other purposes]

If you are preganant, you may not know. It may be weeks before you start to realise you are pregnant, and all this time the growing baby is being given a dose of either estrogen or progesterone or a mixture. Not enough studies have been done on this and its long term effects on the child.

More data is needed, quickly, if only because the speculation is racing ahead of the facts. The latest speculation to emerge from the bowels of the Internet is that some homosexuality and transgenderism is caused by this. But I could find no papers one way or the other to support or refute this.

The side effects of Mis-prescription

The hormones in "the Pill" have also been used to treat other medical conditions, such as polycystic ovary syndrome (PCOS), endometriosis, amenorrhea, menstrual cramps, adenomyosis, menorrhagia (excessive menstral bleeding), menstruation-related anemia and dysmenorrhea (painful menstruation).

In the US, no oral contraceptives have been approved by the U.S. FDA for those uses.

Although the pill is sometimes prescribed to induce menstruation on a regular schedule for women bothered by irregular menstrual cycles, it actually suppresses the normal menstrual cycle and then mimics a regular 28-day monthly cycle. It doesn’t cure the underlying problem, although estrogen imbalance, for example can be one cause.

But a lack of periods can also be caused by nutritional deprivation, and by masking the problem you could end up having a very sick anorexic person on your hands.

Wikipedia
Women who are experiencing menstrual dysfunction due to female athlete triad are sometimes prescribed oral contraceptives as pills can create menstrual bleeding cycles. However, the condition's underlying cause is energy deficiency and should be treated by correcting the imbalance between calories eaten and calories burned by exercise. Oral contraceptives should not be used as a treatment for female athlete triad.

How it works

Why the hallucinations? There are very few hallucinations as a whole if we look at the list below.

Drug cocktails

Where the figures are low, or an isolated case, on examination of each case, it is clear that the person was taking a cocktail of drugs and it could have been any one of those drugs or the mixture itself that caused the hallucination.

Three of the four women who had hallucinations on taking Lo/ovral were on Prozac.

If we take another drug as an example - Junel, we find that the woman was taking

Multivitamins - which in overdose proportions can give hallucinations in their own right
Crestor - which is a statin and statins too have a record for producing hallucinations
Ranitidine - an anti-histamine and drug that decreases stomach acid production that also has record for producing hallucinations
Marcaine, heparin, kenalog, lydicaine, elmiron and last but not least
Nucynta - an opioid analgesic

In the circumstances it seems unlikely that it was the contraceptive that caused the hallucination, and we find similar results for a number of the isolated cases.

Brain damage [temporary]

Of the remaining and higher figure drugs, injectable contraceptives appear to be implicated in more hallucinatory experiences than those taken by mouth, here we can only hypothesise that the drug entered the blood stream from where it got into the brain. They also seem to be the subject of a number of ADRs, for example:

On Feb, 17, 2016: 10,001 people reported to have side effects when taking Depo-provera. Among them, 37 people (0.37%) have Death

Infection [bacterial, viral or fungal]

Intrauterine devices (IUD) classified as long-acting reversible contraceptive methods also seem to have provoked more hallucinations. These have a record for producing infection and it may be the infection that is responsible for the hallucination. The eHealthme site also indicates that they have a record for producing haemorhages, as such blood loss ay also be a cause eg Vaginal Haemorrhage in Mirena (5,172 reports). It is worth pointing out that this class of contraceptive has also caused deaths eg [From eHealthme]
On Feb, 22, 2016: 62,666 people reported to have side effects when taking Mirena. Among them, 15 people (0.02%) have Death.

Mis-prescription

Of those taken by mouth it appears that some are being mis-prescribed and one thing they are being mis-prescribed for is acne! Presumably the thinking is based on the notion that hormones are causing the acne and thus one way of curing the acne is to add more hormones. Five of the 15 people who had hallucinations on Ortho Tricyclen, for example, were also on Accutane - used to treat acne and with an impressive hallucination record of its own.

Blood circulatory effects

Yasmin/Yaz rather stands out in the list below. Whereas the other pills are combinations of synthetic hormones, Yasmin contains Drospirenone, an "aldosterone antagonist with potassium-sparing properties".

Wikipedia
Women who take contraceptive pills containing drospirenone have a six- to sevenfold risk of developing thromboembolism (dangerous blood clots) compared to women who do not take any contraceptive pill, and have twice the risk (some epidemiological studies suggest thrice, according to the FDA) compared to women who take a contraceptive pill containing levonorgestrel

thus the reason for the hallucinations may be related to the effects on blood pressure. It may be worth adding that this class of drug has resulted in a considerable number of ADRs:

On Feb, 21, 2016: 38,290 people reported to have side effects when taking Yasmin. Among them, 68 people (0.18%) have Death
On Feb, 22, 2016: 29,109 people reported to have side effects when taking Yaz. Among them, 24 people (0.08%) have Death
On Feb, 22, 2016: 9,168 people reported to have side effects when taking Drospirenone and ethinyl estradiol. Among them, 9 people (0.10%) have Death

References and further reading

Minerva Endocrinol. 2014 Nov 21. The effect of chronic estrogen application on bile and gallstone composition in women with cholelithiasis. Sieron D1, Czerny B, Sieron-Stoltny K, Karasiewicz M, Bogacz A, Seremak-Mrozikiewicz A, Kotrych D, Boron D, Mrozikiewicz PM. 1Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland - aniabogacz23@o2.pl.
[Psychosis caused by hormonal contraceptives]. Kiss SA, Berecz G. Orv Hetil. 1973 Feb 18;114(7):396-8. Hungarian. PMID: 4686449

Observations

The following table has been compiled by using the figures from Adverse drug reports of hallucinations submitted to the FDA and SEDA by doctors and recorded on eHealthme. The link takes you to the eHealthme site where an up to date list of side-effects for each drug can be found.

Drug	No of hallucinations
Alesse	2
Alyacen 1/35	0
Aviane [21 and 28]	2
Aygestin [Jolivette, Nor-QD, Nora-Be, Ortho Micronor]	1
Beyaz	0
Camila	0
Cryselle	0
Cyclafem	0
Depo-provera	19
Desogen	0
Desogestrel	0
Drospirenone and ethinyl estradiol	0
Enpresse-28	0
Errin	0
Estrostep Fe	0
Femcon Fe	0
Gildess	0
Implanon	5
Junel and Junel Fe	1
Kariva	0
Kelnor	0
Levonorgestrel	0
Levora	0
Lo/ovral	4
Loestrin 21, 24 , Fe	6
Loryna	0
Loseasonique	0
Low-ogestrel	0
Lybrel	0
Medoxyprogesterone acetate	4
Microgestin	0
Micronor	2
Minastrin	0
Mircette	0
Mirena	11
Natazia	0
Nexplanon	0
Nor-qd	0
Nordette	1
Norethindrone	0
Norgestimate	0
Norinyl	0
Norplant	1
Nortrel	0
Nuvaring	6
Orsythia	0
Ortho Cyclen	0
Ortho Evra	3
Ortho Tri-cyclen	15
Ortho-cept	0
Ortho-novum	0
Ovcon	0
Paragard	0
Plan B	4
Portia	0
Previfem	0
Progesterone	9
Quasense	0
Seasonale	0
Seasonique	1
Sprintec	0
Syeda	0
Tri-sprintec and Tri Lo sprintec	0
Tri-legest Fe	0
Tri-linyah	0
Tri-norinyl	0
Tri-previfem	0
Triphasil	8
Trivora	0
Viorele	0
Yasmin	27
Yaz	3
Zovia	0

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