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The Sugar Pills in Your Birth Control Pack Were Put There to Placate The Pope

CARLY CASSELLA
21 JAN 2019

For nearly 60 years, women have been taking the birth control pill in a less than ideal way, and weirdly enough, the reason is not scientific - instead, some of the thinking can be traced back to the Catholic Church.

 

The seven inactive pills, included in most oral birth control packets, are not there for a medical reason. Each time a woman pops out a sugar pill, it is a reminder of a futile attempt to placate the Pope.

When the first birth control pill hit the market in the 1960s, it had a profound impact on society, but just like any great medical breakthrough, its creation was shaped by more than just medicine.

One of the gynaecologists working on the pill, John Rock, was Catholic. He knew that in order for the Pill to be accepted by the Catholic Church and its followers, it would have to be sold as a "natural" form of contraception based on hormones already present in the female body.

While the Church had condemned unnatural contraception like condoms, the rhythm method - which is when couples time sexual intercourse with certain phases of the menstrual cycle - was deemed perfectly normal and acceptable.

According to American journalist Jonathan Eig, the symptoms induced by the hormonal contraceptives made women think they were pregnant, so Rock and his collaborators advised women to skip the pills for five days before starting the next pack, which would trigger a false period and assure them a pregnancy had not taken place.

 

In addition, this usage would make the pill feel more 'natural', and Rock thought this might appease the Catholic Church, too. Of course, it was difficult to correctly count days and remember when to start the next pill pack, so soon enough brands entered the market that marked the off days with sugar pills.

In terms of religious acceptance, all those efforts were made in vain, though. In 1968, years after FDA approval, Pope Paul VI declared all forms of "artificial" contraception to be against church doctrine.

He even tried to pass it off as a favour to women, arguing that "a man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires."

But even though Rock's olive branch failed, by then it was too late. After eight years of being on the market, 'off days', often marked with sugar pills, had became a standard of hormonal contraception, and the withdrawal bleeds they induce were often thought of as necessary, real periods, even though they aren't technically the same.

 

While there hasn't been a long-term study on the continuous use of oral contraceptives, today most gynaecologists agree that bleeding each month is medically unnecessary and that skipping a period is perfectly safe.

In fact, not only is there no apparent harm that accompanies continuous usage, recent research suggests that missing out on a menstrual cycle may actually be beneficial to women in several ways.

A study from 2014, for instance, found that women who continuously took the pill "fared better in terms of headaches, genital irritation, tiredness, bloating, and menstrual pain."

What's more, some research has found that continuous use of oral contraceptives can help patients manage their endometriosis better, reducing pelvic pain, boosting sexual activity, and generally improving the quality of life for this debilitating condition.

It's taken decades, but medical guidelines are finally catching up to the facts. The United Kingdom's National Health Service (NHS) is the latest government body to shake itself free of this common misconception.

Adhering to the best available evidence and expert consensus, the institute's Faculty of Sexual and Reproductive Healthcare (FSRH) has now admitted that there is no health benefit to a seven-day break from the birth control pill, and, as such, this form of birth control can be taken every day of the month.

The new guidelines argue that the consistent use of oral contraceptives "is associated with a reduced risk of endometrial, ovarian and colorectal cancer", not to mention the benefits of "predictable bleeding patterns, reduction in menstrual bleeding and pain, and management of symptoms of polycystic ovary syndrome (PCOS), endometriosis and premenstrual syndrome."

There's even a theory that continuous use of the Pill can reduce the risk of unwanted pregnancies caused by 'escape ovulation', although conclusive evidence supporting this idea is still missing.

"The guideline suggests that by taking fewer hormone-free intervals – or shortening them to four days – it is possible that women could reduce the risk of getting pregnant on combined hormonal contraception," Diana Mansour, vice president for clinical quality at FSRH, told The Independent.

Obviously, not every woman will want to skip their sugar pills. Some might still find it comforting to have their period each month, a reassurance that childbirth is not a reality of the near future.

But we need to equip women with the proper facts. To this day, many women are still unaware that skipping their period is even an option, and many continue to believe that if they do so, they might be putting their health at risk.

Governments should follow the UK's example so that women around the world can make their own decisions about how they want to live their lives. After decades of misinformation and misunderstandings, it's the least we can do.

Editor's note (22 Jan 2019): An earlier version of this article conflated the introduction of the sugar pills, the intent to please the Catholic Church, and the original intent of skipping a few days of hormones, which was to assure users they hadn't fallen pregnant. We've now clarified these facts and apologise for the error.