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Monday, January 31, 2000
CONS
Story by Katie Hollar Photos by Matt Daugherty
She calls them the crazy pills.
Jen Downing, Salina senior, described the two months when she took Ortho Tri-Cyclen, a birth control pill, as absolutely horrible.
"They made me crazy and fat," she said. "They didn't make me feel right. I was in a bad mood all the time." Downing's experience is not uncommon.
In 1995, 33 percent of American women between 20 and 24 were on the pill, according to statistics from the Center for Disease Control.
Indeed, Henry Buck, chief of gynecology at Watkins Memorial Health Center, said the pill was the most popular form of contraception for college women. Buck offered several reasons.
"It's very effective, 10 times or so more than using condoms," he said. "It's relatively inexpensive. Depo-Provera takes three months to get out of your system. Norplant's too expensive and the intrauterine device is not approved for women without children."
Depo-Provera is an injection, administered once every three months, and Norplant capsules are implanted in the skin of the upper arm and are effective for at least five years. if not longer.
Oral contraceptives are composed of two female hormones, estrogen and progesterone. They prevent pregnancy by stopping the ovaries from releasing eggs and by keeping the cervical mucus thick so sperm can't easily pass through it, according to the Merck Manual, a medical encyclopedia.
But unfortunately for the one in three women on the pill, side effects like Downing's are quite common.
The Merck Manual also lists depression as one of several "troubling side effects" and recommends that women who are prone to depression be under close supervision by their physician.
Symptoms of depression related to pill use include pessimism, dissatisfaction, listlessness, tension, crying and even anxiety or a loss of sex drive, as documented by the U.S. Department of Health and Human Services.
Buck said the link between oral contraceptives and depression was not understood very well.
"I'm not sure anybody knows why," he said. "It has to be in the relationship of estrogen and progesterone. I think the phenomenon of depression with the pill is hormonal in nature, but I don't think anyone's ever done any more than speculate. It's a very complicated subject."
Buck said the combination of the two hormones in the pill could play on a woman's volatile hormonal balance.
"It's got something to do with the relationship of hormones and the way hormone receptors metabolize hormones based on an individual's variations," he said.
In other words, every woman's hormone receptors are different, and a pill formula either can fall in synch with those or disagree entirely. Some women click with a pill right away, and others react negatively.
Downing was one of the latter.
In one week, she said, she gained 10 pounds. She said she became crampy and moody almost immediately.
"I felt fat, and I felt pissed off and awful," she said.
Downing said when she told her physician about her depression problems,her concerns were quickly dismissed.
"They said my moodiness was because I was depressed about the weight gain," she said. "I don't believe that."
Oral contraceptives' role in depression could have a different explanation, as depression can sometimes be a symptom of vitamin B-6 deficiency. Pill use can cause this deficiency, studies have found that some depressed pill users are B-6 deficient, according to Health and Human Services.
Laurell Matthews, assistant in the supplement department at Community Mercantile, 901 Mississippi St., said B-6 was needed for normal brain function and may lift depression.
"I see B-6 mixed
Birth Control: The facts and figures
A 1995 study by the Center for Disease Control polled 9,041 American women about contraceptive methods. A majority, 63.4 percent, was using contraception.
33.1% — oral contraception ("the pill")
16.7% — condoms
3.9% — injection (Depo-Provera)
2.5% — female sterilization
2.4% — implant (Norplant)
2.1% — withdrawal
.7% — male sterilization
.6% — periodic abstinence
.4% — diaphragm
.2% — intrauterine device
.1% — female condom
.1% — natural family planning
.9% — "other methods"
Oral Contraceptive Side Effects
■ Bleeding at irregular times during the menstrual cycle
■ Nausea
■ Breast tenderness
■ Bloating
■ Increase in blood pressure
■ Depression
■ Weight gain
■ Acne
■ Nervousness
■ Trouble sleeping
■ Increased risk of blood clots
■ Changed amounts of vitamins in the blood
■ Dark patches on the face
Source: The Merck Manual
with other products taken for depression," she said.
"That's a pretty good link right there," she said.
Matthews said the pill could deplete women of nutrients such as folic acid and B-6.
After two months of misery on Ortho Tri-Cyclen, Downing switched to Ortho Novum, an oral contraceptive with a uniform dose of progesterone instead of the three varying levels in Ortho Tri-Cyclen.
"This one's great," she said. "It's been a really good pill. I don't have any awful girl symptoms." In many cases, pill switching can be successful, Buck said.
Unfortunately, a patient may need to try several different pills before finding the perfect one. And, as Buck said, it's all a prescriptive guessing game.
"There is no real scientific approach to that," he said. "The pills today all have the same estrogen in them; the thing that differs is the progesterone components. Some are weaker, some are stronger. There is no real scientific way to say 'this is the pill for you.'"
Downing said she tried four different brands of the pill before she found success with Ortho Novum.
"There are so many pills you can feel fine on and a handful you don't," she said. "Definitely shop around."
Sumithra Rao, Overland Park freshman, has tried two different pills with only good results. She is now taking Ortho Tri-Cyclen — the same pill that plagued Downing.
"It curbed my mood swings. I don't get PMS," she said. "I've never had any problem whatsoever."