Talk:Combined oral contraceptive pill/Archive 1

message: "Masters and Johnson, among others, reported more than one woman who experienced her first orgasm during intercourse shortly after going on the Pill."
Surely this should read something like:
"Masters and Johnson, among others, reported more than one in four woman who experienced her first orgasm during intercourse shortly after going on the Pill"
:I was under the impression they came across a handful of women who experienced this.  I'm not sure how big their total interview/research group was, but I don't think they had enough 'first orgasm on pill' women to draw a statistically sound conclusion such as one in twenty.Lyrl 02:26, 26 February 2006 (UTC)
thread_title:  "more than one woman who experienced her first orgasm..." 

message: The final section just isn't particularly accurate.
There is no evidence other than anecdote that the pill caused a sexual revolution in the sixties, frankly there is no evidence of a sexual revolution in the sixties. Other than a revolution in the media.
I'm hoping to change this - but it does seem a big job and I am thinking how best to do it - any suggestions??
:I agree with your assessment of the section.  No specific suggestions, but I'll look at it when I have time.  Also, when you post on the talk pages, if you put four tildes at the end ~ ~ ~ ~ (only no spaces), it will 'sign' your comment.  Like this: Lyrl 00:06, 28 April 2006 (UTC)
thread_title:  Social consquences - "sexual revolution" 

message: I am a medicinal chemist who deals in drug design and mechanism of action everyday.  The information I put in is scientifically backed up with verifiable sources - five to be precise.  The conclusions were not reached solely on the factor of STD's and if you would take the time to read the papers you would see that the conclusions do support the figures that I used.  Albeit the lower end of the scale is most likely more accurate...that is not my right to determine but instead I need to use the reported, and peer reviewed data available.  Further you do not source most of your "generally accepted" information.  However, I do source everything I put in there.  Your opinions do not belong here...this is a place for people to get information not be fed propaganda.
:—Preceding unsigned comment added by Jdbrown1998 (talk • contribs)  15:06, 19 May 2006
::This discussion seems to have reviewed the literature fairly thoroughly, and refers specifically to all the studies Jdbrown added as a references in support of extrauterine vs. intrauterine pregnancies being caused directly by combined oral contraceptives.  It comments that "The letter by Job-Spira et al seems to represent the same data set of 279 cases and controls as the study by Coste et al." The meta-analysis by Mol apparently includes that study.  So just one study is effectively being refered to three times; though the meta-analysis does include other studes which apparently (per edits by Davidruben) contradict the assertation of increased extrauterine pregnancy.  The Polycarp Research Institute paper also discounts the WHO study as including women taking progesterine-only pills, which are commonly accepted as directly increasing the risk of extrauterine vs. intrauterine pregnancies. (In addition to that assumption in the Polycarp paper, a Google search for extrauterine pregnancy pill come up mostly with references to the mini-pill.)
::While I unfortunately do not have access to the full text of these studies, I question how well STDs were controlled for.  With study titles such as "Risk of chlamydial PID and oral contraceptives," STDs were obviously a factor in the ectopic pregnancies.  Because women who choose to take COCs are more likely to engage in behavoir that puts them at risk of STDs, that population is going to have a higher ectopic pregnancy rate than the population of women who choose other forms of birth control.  Not because of the hormones they are taking, but because of their behavoir.  
::The increased rate of ectopic pregnancy in COC users would seem to have an explanation in their increased STD rate, not in a postfertilization effect of the COCs.  I would be very interested if someone with access to the studies explained how this confounding factor was taken into account when calculating the increased risk of extrauterine pregnancy due directly to COC use.Lyrl 22:19, 19 May 2006 (UTC)
thread_title:  Lyrl-edits of 18 May 06 

message: --71.230.248.74 00:43, 31 May 2006 (UTC)
replies: text: Estrogen and progesterone are both high during the luteal phase (time between ovulation and menstruation).  They remain high during pregnancy.  Many "pregnancy" symptoms are identical to PMS symptoms, and are caused by the high levels of estrogen and/or progesterone that occur both during the luteal phase and during pregnancy, rather than from any direct action of the embryo or fetus.  As hormonal contraception consists of estrogen and progesterone, it is not surprising that it causes various PMS-like or pregnancy-like symptoms.  I believe all women will have side effects from hormonal contraception; the type and severity of the effects varies widely between brands and between women.  A few side effects, such as breast tenderness and nausea, tend to go away by the third month on the pill. As this information is all anecdotal from my experience and reading, I'm not sure it could be incorporated into the Wiki article - that generally requires sources. Lyrl 03:36, 3 June 2006 (UTC)
replies: text:  Most women don't get morning sickness or nausea during their periods; the first month or so on The Pill and the duration of pregnancy obviously cause nausea (I'm told it goes away wwhen you get used to The Pill). What I was asking was does anyone have a good source we can add to the encyclopedia from, since people like me might look for this kind of info and not check the antecdotal evidence on the talk page Kuronue 03:53, 3 June 2006 (UTC)
thread_title:  OT question by younger user 

message: :The medical consensus is that pregnancy starts with implantation, not fertilization. This definition of pregnancy did not start until the advent of in vitro fertilization — having eggs fertilized in a laboratory is not generally accepted to make a woman pregnant. Many sources do still define pregnancy as beginning with fertilization. Therefore, the determination of whether oral contraceptives are abortificants depends largely on a person's individual definition of pregnancy.
This paragraph probably needs to be rewritten. For starters, the beginning of pregnancy controversy mentions in vitro fertilisation but doesn't say it was the cause of pregnancy being defined as beginning at implantation. It doesn't discuss when and why there was a change, if there was a change (and it wasn't just a pre-existing but probably largely ignored difference in terminology). Secondly the 'many sources' part is a bit of a weasel word IMHO in this context. How many is many? It would be better to say some medical sources or something of that sort maybe. Finally, the bit about "determination of oral... depends..... person's invididual...." is a bit confusing. This article already establishs that no one really know whether oral contraceptives do interfer in implantation. If they don't personal believes on the beginning of pregnancy is irrelevant to the issue at hand. Nil Einne 12:42, 17 June 2006 (UTC)
replies: text: The medical consensus is that pregnancy starts with implantation, not fertilization. However some medical sources do still define pregnancy as beginning with fertilization. Therefore, if oral contraceptives do interfer with implantation, the determination of whether oral contraceptives are abortificants depends largely on a person's individual definition of pregnancy. See Beginning of pregnancy controversy for more information
As you can see, I removed the unsourced bit about the origins of the definition, I've changed the weasel word many and I've made it clear the issue is only relevant ir oral contraceptives do interfer with implanation which we don't know. See my discussion above for more info on why I made my changes. I also added a link to the beginning of pregancy controversy since it should be the primary article. I'm not particularly good at style so maybe it should be mentioned in a different way but at least it's mentioned Nil Einne 12:45, 17 June 2006 (UTC)
thread_title:  Beginning of pregnancy controversy - implantation vs. fertilization, in vitro 

message: It seems there has been some speculation that the pollution of drinking water with synthetic estrogen is affecting human male fertility.  However, there appears to have been no research to support this speculation, and even serious discussions of declining male fertility (like here) dismiss the pill hormone-male fertility theory as "extreme." Lyrl    Talk     Contribs   18:30, 23 July 2006 (UTC)
thread_title: Pill-related polution and human male fertility

message: Sources 7 & 8 listed in this article do not appear to be in the correct place. The article referenced in source 7, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=4052920 , only claims an increase in ectopic pregnancy for IUD users, not oral contraceptive users (which it did not find any significant change to). Source 8 has two problems: first, its link does not directly link to the article; a second link must be followed. Secondly, the article, at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=2293688&itool=pubmed_Abstract , does not deal with ectopic pregnancies at all; indeed, it appears the risk for PID (a risk factor for ectopic pregnancy) is reduced by using the Pill.
--Chiapr 15:37, 24 July 2006 (UTC)
replies: text: I had other problems with that whole section when it was put in (see discussion section #Lyrl-edits of 18 May 06), but I didn't want to get into a revert war at the time and then forgot about it.  If you want to clean that section up, please do. Lyrl    Talk     Contribs   21:29, 24 July 2006 (UTC)
thread_title: Source Problems

message: "Further, married women had control over their family size, even if their belief was that the woman was obligated to submit to her husband's sexual desires — regardless of her interest — which had been a prevailing view in many cultures.  For women with abusive husbands or women who had had high risk pregnancies, this control was potentially lifesaving;  however, it did lead to the conflict of obtaining medication without fully informing the husband.
In time, however, as society adjusted to these new facts, the Pill largely regained its reputation, due to its indisputable effectiveness and convenience. According to some sources, 80 percent of American women use the Pill at some point in their lives."
this is ungrammatical and makes no sense in a number of places, but i think some of the ideas may be worth saving/rephrasing.
for example, i don't see how the pill could be lifesaving for a woman with an abusive husband. ?  or how the pill could be lifesaving in a high-risk pregnancy. (access to contraception could  prevent a high-risk pregnancy in a woman likely to have one due to health conditions, but the pill itself has no effect on a high risk pregnancy...) 
also, i'm not sure that the pill "regained its reputation"--the WHO/IARC recently upgraded it from a possible carcinogen to definitely carcinogenic to humans. it *is* certainly popular, but its reputation viz breast cancer shouldn't be treated as though all concern is gone. and a claim of %80 is rather high (and would need a source other than ortho-tricyclen, even if that link worked...)
Cindery 03:00, 5 September 2006 (UTC)
thread_title: Removed paragraph - "'married women'... 'indisputable effectiveness'"

message: I see that the statement about women going on the pill to increase their breast size has been marked as needing references.  I have no doubt that this is true.  If you search various internet forums you can certainly find this subject being discussed.  What is more relevant is the fact that it doesn't necessarily work.  In particular, low-estrogen pills often cause breast volume reduction due to their progestin content.  It'd be nice if we could find some reliable statistics on that.  -- Kiral 10:03, 5 September 2006 (UTC)
thread_title:  Breast enlargement via the pill 

message: The effect of the Pill on a woman’s sexuality are difficult to judge; depending on the individual and the particular formula, the Pill may enhance or disrupt a woman’s (or couple’s) sex life. Because neither the woman (who uses the Pill) nor her partner need take any special action before or during intercourse, it makes birth control "invisible" and sex spontaneous, more natural, or both. When combined with the Pill’s high degree of effectiveness, this may enable the couple, and especially the woman, to relax more easily during sex. Masters and Johnson, among others, reported more than one woman who experienced her first orgasm during intercourse shortly after going on the Pill.
On the other hand, the Pill’s various side effects may prove disruptive on a physiological or even a psychological level. The hormonal disruption caused by the Pill may result in mood swings, lower libido, excessive or insufficient vaginal lubrication during intercourse, and possibly an injured self-image due to weight gain. Some women who use the Pill despite the teachings of their religious traditions may feel conscious or unconscious guilt; others may not fully trust an "invisible" method of birth control. This wide range of variables makes prediction of the Pill's effect on sexuality difficult, but the fact that the Pill can and does have an impact in this area, for good or for ill, is well-documented.
...i moved this here for now because it doesn't cite a single ref. no doubt some of these assertions are valuable and can be backed up, but the style is editorial/subjective in addition to citing no refs. whole thing should be rewritten/restyled/sourced.
Cindery 20:34, 7 September 2006 (UTC)
thread_title: Effects on sexuality

message: Source problem: "The theory that the pill has postfertilization effects is also based on some studies that found the ratio of extrauterine to intrauterine ratio of pregnancies increases by 70–1390% in women using the pill". 13,14 and 15 is listed as sources, but none of them (14 was a comment/letter that was not available) seems to reach the conclusion stated in this sentence. The article listed as source nr 13 ("A multinational case-control study of ectopic pregnancy...") in fact states that there was NO connection between XU-pregancies and OC. Number 15 ("Risk factors for ectopic pregnancy: a case-control study in France, with special focus on infectious factors.") states some connection between contraceptives, but does not discriminate between IUD and OC- which of course makes a huge difference in this context. 
-J-
:See #Lyrl-edits of 18 May 06 and #Source Problems for prior discussion.  I would be happy to see cleanup of that section. Lyrl    Talk     Contribs   13:00, 28 September 2006 (UTC)
thread_title:  Extrauterine pregnancies 

message: The "History" section says: "Carl Djerassi, a young Bulgarian chemist, [...].  Djerassi was born in Vienna, Austria in 1923.  While escaping Nazi persecution, he spent 2 years in Bulgaria (1939-1941) before fleeing to the United States.  Djerassi is Austrian, not Bulgarian.—Preceding unsigned comment added by AdderUser (talk • contribs) 
:Djerassi is American. His Viennese mother and Bulgarian father met in medical school at the University of Vienna, married and moved to Sofia, Bulgaria. His mother returned to Vienna for two months for the birth of her only child. Djerassi lived in Bulgaria with his parents until he was five. He and his mother then moved to Vienna where he attended a Realgymnasium until age fourteen, spending summers in Bulgaria with his father who had divorced his mother. After the Anschluss, his father briefly remarried his mother to allow Djerassi to escape to Bulgaria in 1938 where he lived with his father for a year attending the American College of Sofia while his mother went to England to await a visa to emigrate to the United States. At age sixteen, Djerassi and his mother arrived nearly penniless (they had only $20) in the United States in 1939. Djerassi married his first (American) wife in 1943 before beginning graduate study at the University of Wisconsin-Madison where he earned his Ph.D. and became an American citizen in 1945. He worked for Ciba the year before and four years after his graduate studies. In 1949, he was recruited to be the associate director of research at Syntex in Mexico City by then technical director George Rosenkranz, and worked there from 1950-1951 and again from 1957-1960 (while on a leave of absence from Wayne State University before moving to Stanford University).
:68.253.191.144 16:03, 19 October 2006 (UTC)
replies: text: Thank you.  I have moved this info to the Carl Djerassi page.  You might wish to make further edits and quote sources.--Grahamec 22:58, 19 October 2006 (UTC)
thread_title:  Djerassi is Austrian, not Bulgarian 

message: There is no information included in the article about the proportion of women taking the birth control pill. I would believe that  statistics to this effect would be important in understanding the social and cultural aspects of birth control.
Nealc9999 05:13, 29 November 2006 (UTC)
replies: text: The information is limited, but there is some there.  From the very first paragraph in the article: usage prevalence varies: one quarter of reproductive age women in the United Kingdom take the pill,[1] but only 1% of women in Japan.[2] If you're interested in the topic, I would encourage you to do the research needed to create a section on "Prevalence" or equivalent. Lyrl    Talk     Contribs   23:43, 29 November 2006 (UTC)
thread_title:  Proportion of women using oral contraceptives 

message: :Add  # Support  or  # Oppose  on a new line in the appropriate section followed by a brief explanation, then sign your opinion using ~~~~.
====Survey - Support votes====
Support - I proposed something similar several months ago (here). Lyrl    Talk     Contribs   02:41, 22 December 2006 (UTC)
thread_title: Survey

message: Support - I proposed something similar several months ago (here). Lyrl    Talk     Contribs   02:41, 22 December 2006 (UTC)
thread_title: Survey - Support votes

message: This is intended to be a space where people can discuss this change, if necessary.  Although of course I support my own suggestion, I wasn't aware that others would take such quick action to make the move: I suggested this move on the 21st.  Lyrl surprised me by making the move on the 23rd, and then Mets501 closed the debate on the 27th.  It is possible that some people might have been on vacation or busy with their families during Christmas.  If anyone feels they were not given enough time to voice their opinion, please feel free to do so, here.  18:20, 27 December 2006 (UTC)
thread_title: Move of Oral Contraceptive contents to "Combined oral contraceptive pill"

message: Note discussion at Talk:Birth control#"pregnancy rate" rather than "failure rate" re replacing occurrences of "failure rate" with "pregnancy rate".  I would also like to see the same change on this page.  Please make any comments there.  --Coppertwig 04:04, 8 January 2007 (UTC)
thread_title:  "Pregnancy rate" rather than "failure rate" 

message: I don't want to diminish his contribution but he made a batch of synthesized progesterone from sterols, which was not on the path to the BCP. It was Syntex and Upjohn that made the estrogen analogues that comprise the BCP. --Richard Arthur Norton (1958- ) 21:07, 7 February 2007 (UTC)
thread_title:  Percy Lavon Julian 

message: :Sexuality (Libido decrease)
:*Hatcher & Nelson (2004), p. 403:
:**Other potential health benefits
:***Influence on sexual enjoyment. OC use may increase sexual pleasuring, either by increasing libido (less concern about pregnancy) or increasing lubrication. On the other hand, some OC users report decreased libido and more vaginal dryness.
:*Hatcher & Nelson (2004), p. 432:
:**Libido decrease 
:***Though infrequent, decreased libido is occasionally a problem and may be the reason a woman seeks a different pill or a different contraceptive. When a patient notes a decrease in libido, also ask about depression as both symptoms may occur in the same patient. In some women, the pill alters vaginal secretions and decreases levels of free testosterone, both of which may decrease libido. An estrogen deficiency may decrease vaginal lubrication and make sexual intercourse less comfortable and occasionally painful. Consider the vaginal ring to increase lubrication. Even if the initiation of OCs is accompanied by a clear loss interest in sex or an inability to have orgasms, evaluate other potential causes of decreased libido or anorgasmia, including depression. Many women, however, may find more enjoyment from sex because the risk of pregnancy is reduced.
:*Hatcher & Nelson (2004), p. 434:
:**Vaginal discharge
:***Some women notice an increase in vaginal secretions with estrogen-containing contraceptives. These secretions are generally not an indication of infection. Women who use low OCs are not at any increased risk of developing uncomplicated candidal infections or bacterial vaginosis (BV). Reassurance is generally the only intervention needed once infection has been ruled out. Point out to the woman that these secretions are healthy and serve as a lubricant during coitus.
:*Speroff & Darney (2005), p. 72:
:**Other Metabolic Effects
:***Though infrequent, a reduction in libido is occasionally a problem and may be a cause for seeking an alternative method of contraception.
:*Glaiser (2006), p. 2999:
:**Minor Side Effects
:***The combined pill is associated with a variety of minor side effects probably common to all combined hormonal contraceptives regardless of delivery system. Nausea (rarely persistent), breakthrough bleeding, chloasma, and breast tenderness are all attributable to the steroid hormones. Mood change and loss of libido are but two of a list of common complaints less clearly related to the drugs.
:*Westhoff et al. (2007). Oral contraceptive discontinuation: do side effects matter? Am J Obstet Gynecol. , p. 412.e6:
:**The association between OC use and libido has received attention in the popular press; our results that show essentially no change in sexual satisfaction among our OC users may help to deflate this emerging myth.
:From the earliest days over half a century ago, development of the Pill has involved a trade-off between the most common adverse effect, breakthrough bleeding, versus most other adverse effects (breast tenderness, nausea, etc.) and rare but serious health effects (risk of venous thrombosis, stroke, myocardial infarction, etc.) as estrogen (and progestin) doses are reduced.
:The current Side effects section of this article gives undue weight to three adverse effects: weight gain (Weight), libido decrease (Sexuality), and depression (Depression), of which the medical consensus is the COCP does not cause, or are infrequent and not clearly related to COCP use.  
:The residual "Other effects" subsection is a hodgepodge, listing:
:* vaginal discharge - a vague description - the estrogen in COCPs can cause leukorrhea
:* changes in menstrual flow - a vague description - COCPs reduce menstrual flow — an advantage — not an adverse effect (except where real or perceived amenorrhea causes concern about possible unintended pregnancy)
:* breakthrough bleeding - THE most common adverse effect of COCPs
:* nausea - an adverse effect of previous high-estrogen-dose COCPs; may be no more common with current low-dose COCPs than with placebos
:* vomiting - an adverse effect of previous high-estrogen-dose COCPs; may be no more common with current low-dose COCPs than with placebos
:* headaches - not an established adverse effect of COCPs
:* changes in the breasts - a vague description - COCPs can cause breast tenderness or mastalgia (an adverse effect) and breast enlargement (not always perceived as an adverse effect)
:* changes in blood pressure — a vague description - COCPs can cause increased blood pressure, but the effect is clinically insignificant with current low-dose COCPs
:* skin problems — a vague description - previous high-dose COCPs (like pregnancy) could cause melasma; this is now rare with current low-dose COCPs
:* skin improvements — a vague description - acne improves on current low-dose COCPs; 4 COCPs (with 4 different progestins) have approved indications for treatment of acne: Ortho Tri-Cyclen, Estrostep and Yaz in the U.S. and Alesse in Canada.  
:BC07 04:41, 16 July 2007 (UTC)
thread_title: Libido decrease

message: I propose removing this article from :Category:Human reproduction.  I have proposed narrowing the scope of that category at Category talk:Human reproduction.  Please comment on the category talk page. Lyrl    Talk     C   14:59, 17 March 2007 (UTC)
thread_title:  Category:Human reproduction 

message: What happens if a man takes the female contraception pill? Will you grow breasts? Also, if your on the pill are there any drugs that can interfere with the pill? I mean drugs like MDMA, LSD etc. —Preceding unsigned comment added by 19:08, 10 April 2007 (talk • contribs) 88.105.13.211
:Not encyclopaedic to speculate on unused off-license usage. As for interference - yes some drugs do interfer with teh effectiveness of teh combined pill, thereby increasing the risk of contraceptive failure - see article re commonly accepted (but perhaps lacking in evidence) role for broad spectrum antibiotics. Also liver enzyme inducing drugs may increase metabolism of the hormones (some anti-eplipesy drugs and rifampicin) - such details though largely belong to prescribing formularies and medical textbooks, rather than this a general encyclopaedia. David Ruben  Talk  23:46, 10 April 2007 (UTC)
replies: text: It's not encyclopedic to *speculate*, but it would be encyclopedic to maybe briefly mention what the effects on a male would be if there were good sources to back it up. In fact I came to this page looking for an answer to the question too.  --Krsont 00:25, 29 April 2007 (UTC)
thread_title:  What happens if a man takes the pill 

message: Revised from:
:Incr. DVTs, strokes, breast cancer
to:
:Increased DVTs;
:Increased strokes & MIs if other risk factors present
References:
* Hall JE (2005). "Infertility and Fertility Control" in Kasper, et al. (eds.) Harrison's Principles of Internal Medicine, 16th ed. , p. 282:
:Table 45-2. Oral Contraceptives: Contraindications and disease risks
::II. Disease risks
:::A. Increased
::::1. Coronary heart disease—increased only in smokers > 35; no relation to progestin type
::::3. Venous thrombosis—relative risk ~4; markedly increased with factor V Leiden or prothrombin-gene mutations
::::4. Stroke—increased only in combination with hypertension; unclear relation to migraine headache
:::C. No effect
::::1. Breast cancer
* Hatcher RA, Nelson A (2004). "Combined Hormonal Contraceptive Methods" in Hatcher et al. (eds.) Contraceptive Technology, 18th ed. , p. 404-5:
:Health Complications
::1. Myocardial infarction (MI). A pivotal U.S. study showed that low-dose OCs (< 50 mcg EE) do not significantly increase the risk of MI or stroke in healthy, non-smoking women.
::2. Stroke in high-risk women. In 2002, a World Health Organization (WHO) panel found no significant increased risk of ischemic or hemorrhagic stroke among non-smoking women with no history of migraine headaches who use low-dose (≤ 35 mcg EE) OCs, as did a subsequent study.
* Speroff L, Darney PD (2005). A Clinical Guide for Contraception, 4th ed. , p. 65:
:Oral Contraceptives - Summary: Oral Contraceptives and Thrombosis
::Low-dose oral contraceptives (less than 50 µg ethinyl estradiol) do not increase the risk of myocardial infarction or stroke in healthy, nonsmoking women, regardless of age.
* Mishell DR Jr (2004). "Contraception" in Strauss & Barbieri (eds.) Yen & Jaffe's Reproductive Endocrinology, 5th ed. , pp. 913-5:
:Oral Steroid Contraceptives - Cardiovascular Events - Stroke
::The results of these recent epidemiologic studies indicate that use of low-dose estrogen-progestin OC formulations by nonsmoking women without risk factors for cardiovascular disease is not associated with an increased risk of MI or ischemic or hemorrhagic stroke. These data reveal that smoking is a risk factor for arterial, but not venous thrombosis.
:Oral Steroid Contraceptives - Neoplastic Effects - Breast Cancer
::Because estrogen stimulates the growth of breast tissue, there have been concerns that the high dose of exogenous estrogen in OCs could either initiate or promote breast cancer in humans. Accordingly, numerous epidemiologic studies have been published in which breast cancer risk among OC users has been determined.
::This vast amount of epidemiologic data showing small or no changes in relative risk of breast cancer with OC use is very reassuring. It appears that the dose or type of either steroid, as well as duration of OC use, is not related to breast cancer risk. Because there is no relation between dose or duration of use of estrogen, it is unlikely that OCs initiate breast cancer. The collaborative analysis found that there was no significant increase in breast cancer risk with OC use at very young ages or use before a first birth.
::Furthermore, the contraceptive steroids probably act to promote the growth or increase the chance of diagnosis of existing cancers because breast cancer has been thought to usually take many years to become clinically evident after the cancer is initiated. The epidemiologic findings are compatible with the hypothesis that OC use, like early first-term pregnancy, increases the risk of breast cancer diagnosis at a young age with no appreciable effect on lifetime risk of breast cancer and no change in risk during the perimenopausal years when the disease becomes most common.
69.208.186.119 22:06, 3 May 2007 (UTC)
thread_title:  Infobox risks 

message: :::I am really not sure what arguments BC07 is making here.  They have put in capital letters that their position is supported by RELIABLE SOURCES, and implied that all my opinions are uninformed and therefore wrong.  I consider myself in good company, then - from Gregory Pincus, "Experience with the use of progestinestrogen preparations as oral contraceptives indicates that they inhibit fertility" and he goes on to call these preparations "antifertility agents".  The U.S. Patent Office also seems to have considered an application that states "The ability of the female sex steroids, namely estrogens and progesterone, to inhibit fertility in mammals has been known for many years." and that "Combination oral contraceptives are the most commonly used method for the hormonal suppression of fertility."  I will readily acknowledge that this definition is less common than the self-referencing "oral contraceptives are contraceptives" definition, but I'm confused by the implication that my preferred definition is wrong.
:::BC07 and I also seem to have had a miscommunication on the definition of fertility.  From Merriam Webster:
:::*fertility
:::**1  : the quality or state of being fertile
:::**2  : the birthrate of a population  
:::When I was commenting on fertility vs. infertility of a person and their choice of contraceptive, I had definition #1 in mind.  BC07 responded by quoting an author that talks about contraceptives with respect to definition #2 (contraceptives lower the birthrate of the population using them).  Google searches have many shortcomings, but one of their strengths is showing how words and phrases are most commonly used.  Searches for condom "inhibit fertility" condom "suppress fertility" and condom "prevent fertility" each yield about 100 total results, a large majority of which use "inhibit fertility" and related terms to refer only to things that cause individuals to be subfertile despite barrier-free intercourse (definition #1), not referring to deliberate use of barrier methods.  Using "inhibit fertility" and related terms to refer to contraceptives as a group (definition #2) appears to be a much less common usage - about 10% of hits using these searches.
:::As far as history, the "oral contraceptives are contraceptives" definition was only in place for three months of this article's history (the first year or so did not give a definition in the opening sentence).  More than two years followed that included both the "are contraceptives" and the "inhibit fertility" definitions.  The "are contraceptives" portion was then removed, and the article stayed like that for another two years.  This pretty clearly supports that there is community consensus to include "inhibit fertility" in the opening sentence, and I'm confused by BC07 presenting the history as if it should support their position. LyrlTalk     C   19:38, 13 October 2007 (UTC)
thread_title: Reply

message: There is a very common perception that hormonal contraceptives cause weight gain.  One editor has produced quite an array of sources (including placebo-controlled trials) that conclude modern low-dose formulations, at least, have no effect on weight (see #Weight gain).  Another editor has offered the theory that heavier women do not experience weight gain, but thin women are more likely to experience weight gain (see Talk:IntraUterine System#Literature Omissions About Verifiable Side Effects).  Due to these conflicting opinions, it was suggested at Template talk:Infobox Birth control#Weight change entry that the infobox for hormonal contraceptions say "Weight - No proven effect".  This acknowledges both the lack of authoritative studies showing weight gain as a side effect while not outright denying the common perception of women using the method (or, at least I hope that's what it would do).
I've posted messages at the other hormonal contraception articles asking for discussion here on this topic (it would be nice to treat this uniformly across these related articles, and this seems to be the highest visibility out of the bunch).  So, how do others feel about changing the "Weight" parameter in the infobox to "No proven effect"? LyrlTalk     C   21:26, 20 August 2007 (UTC)
thread_title:  Weight parameter in infobox 

message: In February 2007, as part of its NOVA series, PBS aired the television program Forgotten Genius dramatizing the life of the chemist Percy Julian. For storytelling purposes, parts of the television program and its companion website are misleading and exaggerate the effects of some of Julian's work. One misconception fostered by the television program and its companion website is that Julian played a role in the history of the Pill when he did not.
Since February 2007, three anonymous users have added inaccurate and extraneous paragraphs about Percy Julian to the History section of this article 13 times:
# added 14:38 02 Feb 2007 by 141.149.208.54 --- removed 03:46 07 Feb 2007 by Richard Arthur Norton (1958- )
# added 13:02 07 Feb 2007 by 141.149.208.54 --- removed 21:04 07 Feb 2007 by Richard Arthur Norton (1958- )
# added 23:01 07 Feb 2007 by 141.149.208.54 --- removed 04:03 08 Feb 2007 by Richard Arthur Norton (1958- )
# added 16:50 08 Feb 2007 by 141.149.208.54 --- removed 01:39 12 Feb 2007 by Richard Arthur Norton (1958- )
# added 03:43 13 Feb 2007 by 141.149.208.54 --- removed 23:42 13 Feb 2007 by Lyrl
# added 23:59 14 Feb 2007 by 141.149.208.54 --- removed 02:42 31 Mar 2007 by Lynn4
# added 13:51 26 Aug 2007 by 71.123.29.191 ---- removed 18:48 26 Aug 2007 by Lynn4
# added 15:20 29 Aug 2007 by 71.182.123.65 ---- removed 17:29 29 Aug 2007 by Lynn4
# added 21:43 29 Aug 2007 by 71.182.123.65 ---- removed 21:44 29 Aug 2007 by Oxymoron83
# added 21:48 29 Aug 2007 by 71.182.123.65 ---- removed 21:48 29 Aug 2007 by Ohnoitsjamie
# added 21:52 29 Aug 2007 by 71.182.123.65 ---- removed 21:53 29 Aug 2007 by Ohnoitsjamie
# added 21:55 29 Aug 2007 by 71.182.123.65 ---- removed 21:55 29 Aug 2007 by Ugen64
# added 03:35 31 Aug 2007 by 71.182.123.65 ---- removed 07:15 02 Sep 2007 by Lynn4
The History section of this article is based on books about the history of the Pill, supplemented by journal articles to fill in details:
:Oral contraceptives -- History 
::Asbell (1995) The Pill : a biography of the drug that changed the world
::Marks (2001) Sexual chemistry : a history of the contraceptive pill
::Watkins (1998) On the pill : a social history of oral contraceptives, 1950-1970
::McLaughlin (1982) The pill, John Rock, and the church : the biography of a revolution
::Djerassi (2001) This man's pill : reflections on the 50th birthday of the pill
:Oral contraceptives
::Vaughan (1970) The pill on trial
:Birth control -- United States -- History
::Tone (2001) Devices and desires : a history of contraceptives in America
::Reed (1978) From private vice to public virtue : the birth control movement and American society since 1830
:Hormones
::Maisel (1965) The hormone quest
:Steroid drugs
::Applezweig (1962) Steroid drugs
:Steroid hormone industry
::Gereffi (1983) The pharmaceutical industry and dependency in the Third World
:Contraception
::Speroff & Darney (2005) A clinical guide for contraception, 4th ed.
All of the above books on the history of the Pill devote at least a few paragraphs, and sometimes entire chapters, to Russell Marker and Syntex because of their important roles in the history of the Pill.
None of the books on the history of the Pill even mention Percy Julian because he did not play a role in the history of the Pill.
 
Three of the above books are devoted entirely to the history of the Pill: Asbell (1995), Marks (2001), and Vaughan (1970).
:In Asbell (1995), the first two pages of the first chapter and the entire sixth chapter are about Russell Marker. 
::Russell Marker is the first person mentioned in the book.
:In Marks (2001), the second page of the Introduction and a substantial part of the third chapter are about Russell Marker. 
::Russell Marker is the first person mentioned in the book.
:In Vaughan (1970), most of the first chapter is about Russell Marker. 
::Russell Marker is the fourth person mentioned in the book (after Sanger, Pincus, and McCormick).
Marks (2001) page 2:
Challenging previous histories, which have championed the pill as a North American product that fuelled the sexual revolution, this book suggests that its roots and the effects of its adoption were much more diverse and can only be understood within a wider international framework. As Chapters 2 and 3 suggest, much of its chemical evolution lies in the rise of the lucrative sex hormone industry in Europe during the early twentieth century, and the migration of refugee scientists to the American continent in the wake of fascism and the Second World War. Born out of the race to find easier and cheaper methods of making sex hormones, and the discovery of the anti-arthritic drug cortisone in 1949, the pill emerged from the research of an ingenious yet fickle chemist called Russell Marker (1902-95) on the Dioscorea plant, a wild yam vine which clings to the trees in the mountains of southern Mexico.
Lynn4 07:08, 2 September 2007 (UTC)
thread_title:  Percy Julian 

message: In the United States, at least, there is a good deal of controversy over postfertilization mechanisms of hormonal contraceptives. For example, many pharmacists are now refusing to dispense prescriptions for COCPs because they believe the pills cause abortions .  The current version of the article states, "insufficient evidence exists on whether [these] changes... prevent implantation", which is my understanding of the situation.  However, the current version goes on to state, "endometrial changes are unlikely to play an important role, if any, in the observed effectiveness of COCPs" (bolding mine).  I believe this last sentence violates NPOV because it argues one point of view (postfertilization mechanisms do not exist).  
The current paragraph does not explain that some groups have labeled COCPs as abortifatients because of the possible postfertilization mechanisms.  I believe the paragraph is also misleading because it implies endometrial changes are the only possible postfertilization mechanism, when in fact several such mechanisms have been proposed.
The current paragraph is 61 words long.  I had modified it to address my concerns (mention controversy over postfertilization mechanisms, that more than one such mechanism has been proposed, remove POV).  The resulting paragraph was 103 words.  I do not believe this length presents problems with undue weight of postfertilization effects in comparison to the primary mechanism of action (which has three paragraphs devoted to it) or the uncontroversial effect of COCPs on cervical mucus (which has one paragraph).
My modification was reverted with the comment that the sources I used were poor.  The editor also linked to the most recent archive.  No section was linked, but I suspect the editor was thinking of postfertilization effects, where (s)he had criticized the peer-reviewed paper I used as a source: it was written by family physicians, not by "experts on hormonal contraception".  This editor also linked to the other paper I used as a source, as evidence that that first paper did not represent a majority view.  Since my point in using the sources was to imply there was no majority view, I don't understand how this July 2007 statement (which was added on to a conversation I had in December 2006) explains this reversion of my edits.
I would appreciate a more specific explanation, and also any input other editors have on my edit. LyrlTalk     C   00:41, 28 February 2008 (UTC)
thread_title:  Postfertilization mechanisms