Guest guest Posted January 26, 2010 Report Share Posted January 26, 2010 It was just pointed out to me also that the American Cancer Society post on the link between the Pill and breast cancer is also old - I guess it made the rounds to me again through a couple of lists and Facebook and I didn't look at the date and assumed it was new. There goes my OTHER foot! Ha! I thought ACOG might be responding because of some new press, but it doesn't appear to be new. Just passing this along in case anyone else were trying to access the statement. Dr. Fehring sent me a consoling message about putting my foot in my mouth on this list, so I appreciate that. It's always lovely to participate in a list that is full of Christian charity as well as zeal for our cause. Seriously. Thanks - I do hope a statement can be prepared. Pam Pilch Catholic Nursing Mothers League Dr. Fehring, as soon as I posted this and walked away from the computer, I thought of you and CMR and realized that YOU ARE there. Thank you for reminding me. I will spend more time with your resources, as I used to do, when I had more NFP clients. I'm guessing this ACOG statement came out in response to the American Cancer Society's posting the information about the Pill increasing the risk of breast cancer? I understand the concern that NFP-oriented physicians will be marginalized if they speak out challenging the ACOG statement, and I agree all the time with the point made here by you and others those on " our " side need to be scrupulously careful in what we claim the research says and doesn't say. Still, I would love to see a carefully drafted statement in response that we lay people could use in our advocacy. This ACOG statement makes it sound like we should all be on the Pill from the onset of puberty because it's so extremely healthy.... Thank you for responding - I do appreciate your work and your emphasis on careful research. Pam Pilch Catholic Nursing Mothers League P.S. Sometimes I wonder if I have ever posted anything to this list that didn't amount to putting my foot in my mouth. Pam: There is a website that reviews, analyzes and critiques NFP and family planning studies. I do so for the NFP Department of the United States Conference of Catholic Bishops – it is called Current Medical Research in NFP. Although I review studies in NFP, I also review research studies that show the health risk of hormonal contraception. The reviews are also in hard print in the journal of the Catholic Medical Association – The Linacre Quarterly. The trouble with the statement from ACOG is that it is not a research study – and essentially true in regards to the effects of the pill. But it is not balanced in that it does not point out all of the risks associated with the pill and the fact that fertility is not a disease. Dr. Pavela pointed out the associated risk with cancer, but there is also the risk of stroke and bone loss. I just reviewed a study that was in the January issue of the journal Contraception that showed a 5% decrease in bone density in young women who are using oral hormonal contraception. See review below. The CMR can be found at: http://www.usccb.org/prolife/issues/nfp/cmr.shtml J. Fehring, PhD, RN Professor and Director Office of Research and Scholarship Marquette University College of Nursing Prolonged Use of Oral Hormonal Contraceptives Found to Decrease Bone Mass Density among Young US Women The number one method of contraception among adolescents and young women in the United States is oral contraceptives (OCs). Furthermore, OC use is highest and most prolonged among women when they are undergoing a critical time of bone growth. Previous study results are mixed on the effects of OCs on bone growth in young women and adolescents. Few of the studies are population based. Therefore, researchers from Washington set to determine the relationship of OC use, duration, and estrogen dose on bone mineral density (BMD) among a population based sample of women between the ages of 14 to 30 years. The participants for this study were selected from a large group cooperative practice in the Pacific Northwest. The researchers sent invites letters to participate to 1549 women who had current OC prescriptions and 1199 comparison women. From these women, they enrolled 389 current OC users and 217 non-users. Of these 301 were 14-18 years old and 305 were 19-30 years. All participants completed a questionnaire on their health, reproductive, and family planning history and their BMD measured at the hip, lumbar spine and whole body with a duel-energy X-ray absorptiometry. The researchers found that the mean BMD levels at all anatomic sites among the 14-18 year old participants did not differ significantly. However, among the 19-30 year old group, mean BMD was significantly lower for increasing with duration of use of OCs for the spine and whole body. For example, the BMD was 5.9% lower at the spinal site with great than 24 months of use of OCs. They also found that the BND was significantly lower with OCs with lower doses of synthetic estrogens, i.e., less than 30 mcg. Overall, means of the OC group showed significantly lower (5.2%) mean spine BMD as well. The authors pointed out that among postmenopausal women a 5% decrease in BMD is associated with 50% more osteoporotic fractures. They concluded that prolonged use of OCs may impact the BMD of young women using these methods of family planning. Comments: The authors recommended that further study is needed on the optimal dose and duration of OCs for young women in regards to bone health. However, they also pointed out that the risk of a lower BMD must also be weighed in the context of the risk for an unintended pregnancy. There was no mention of the use of non-hormonal (condoms or natural family planning) and chastity among unmarried adolescents and young adults. S. Scholes, L. Ichikawa, A.Z. LaCroix, et al., “Oral contraceptive use and bone density in adolescent and young adult women. Contraception, 2010; 81: 35-40. From: nfpprofessionals [mailto:nfpprofessionals ] On Behalf Of Pamela Pilch Sent: Tuesday, January 26, 2010 11:01 AMTo: nfpprofessionals Subject: Re: ACOG's latest I do wish that there were a website where those of us who are not MDs or medically-trained could get help analyzing the research that underlies (or purports to) statements like this from ACOG and others. Lamaze International has a weblog where an expert in evidence-based maternity practices (Henci Goer) responds to various studies that come out and helps the certified childbirth educators understand how to read the studies and put them in context for their students, so that students can give fully informed consent. I would love to see a regular feature at One More Soul or somewhere that would do the same thing. I often talk to non-Catholics about the dangers of artificial contraceptives, and now that this ACOG announcement has come out, I really need help being able to tell them WHY the underlying studies are faulty. Reading and understanding research studies is a skill that I need to improve, but a central resource where our experts here could help us out and we could send students to the explanations would also be wonderful. Of course, it would draw publicity to " our " experts and risk marginalization, etc. I don't know what the answer is to that concern. Pam Pilch Catholic Nursing Mothers League On Tue, Jan 26, 2010 at 11:42 AM, Pavela, L., M.D. wrote: Didn’t the WHO classify oral contraceptives as Group 1 carcinogens in 2005; specifically increasing cervical, breast, and liver cancers? I see no recognition of this fact in their release. Pavela, MD Internal Medicine La Crosse, WI From: nfpprofessionals [mailto:nfpprofessionals ] On Behalf Of Hanna Klaus Sent: Tuesday, January 26, 2010 9:43 AMTo: nfpprofessionals Subject: RE: ACOG's latest Here is the press release: · 1 For Release: December 21, 2009 Hormonal Contraceptives Offer Benefits Beyond Pregnancy Prevention Washington, DC -- Hormonal contraceptives are effective in treating menstruation- related disorders such as dysmenorrhea and heavy menstrual bleeding, as well as preventing unplanned pregnancies, according to a new Practice Bulletin issued today by The American College of Obstetricians and Gynecologists (ACOG) and published in the January 2010 issue of Obstetrics & Gynecology. In addition, combined contraceptives containing both estrogen and progesterone offer disease prevention by reducing the risk of developing endometrial, ovarian cancer, and colorectal cancer. More than 80% of women in the US will use some form of hormonal contraception during their reproductive years. There are several different forms of hormonal contraception including pills, patches, implants, injections, vaginal rings, and the intrauterine device (IUD). Pregnancy prevention is the primary reason that most women use hormonal contraception. However, these contraceptives are also frequently prescribed specifically for non-contraceptive reasons, which is considered off-label use. " We've known for many years that hormonal contraceptives have health advantages beyond preventing pregnancy, " says L. Reid, MD, of Kingston, Ontario, who led development of the document. " These recommendations examine the scientific data supporting the non-contraceptive uses of hormonal contraceptives to treat specific conditions. " For instance, both oral contraceptives and the single-rod progestin implant help relieve or reduce the symptoms of dysmenorrhea (severe menstrual pain), the most commonly reported menstrual disorder. Dysmenorrhea affects up to 90% of young women and is a leading cause of women missing school and work. A variety of hormonal contraceptives are also useful in treating menorrhagia (excessive menstrual bleeding), which, if left untreated, can lead to anemia. All forms of birth control that contain both estrogen and progesterone have the potential to improve hirsutism (excess hair growth) and acne because they suppress production of the male hormone, androgen. Other potential benefits of hormonal contraceptives include prevention of menstrual migraines, treatment of pelvic pain due to endometriosis, and treatment of bleeding due to uterine fibroids. " Combined oral contraceptives are effective in normalizing irregular periods, reducing symptoms of premenstrual dysphoric disorder, improving acne, and allowing women to avoid having their period at inconvenient times, such as during a business trip, vacation, or honeymoon , " says Dr. Reid. " Although there is little data on the newer forms of hormonal contraception in terms of their off-label benefits, experts suggest that they may be as effective as the more studied ones in treating the same conditions. " The scientific evidence shows that the longer a woman uses the birth control pill, the lower her risk for developing endometrial and ovarian cancer later, up to 20 years after discontinuing use. The pill also seems to offer some short-term protection against colorectal cancer among current or recent users. Practice Bulletin #109, " Non-contraceptive Uses of Hormonal Contraception, " is published in the January 2010 issue of Obstetrics & Gynecology. # # # The American College of Obstetricians and Gynecologists (ACOG) is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 53,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care. Set Home Page to ACOG | Privacy Statement | Important Disclaimer | Copyright Information | Terms of Use | Contact Us Copyright © 2010 American Congress of Obstetricians and Gynecologists. All rights reserved. From: nfpprofessionals [mailto:nfpprofessionals ] On Behalf Of Pamela Pilch Sent: Monday, January 25, 2010 10:25 PMTo: nfpprofessionals Subject: Re: ACOG's latest Sorry, Dr. Klaus - nothing came through on this e-mail in my inbox. Is it missing an attachment? Pam Pilch Catholic Nursing Mothers League Hanna Klaus, M.D.Natural Family Planning Center of Washington, D.C. and Teen STAR Program8514 Bradmoor DriveBethesda, MD 20817-3810Tel. , Fax http://www.teenstarprogram.org Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.