
Dr Sarah E. Hill: ‘A blind spot about how the pill influences women’s brains’ - laurex
https://www.theguardian.com/society/2019/oct/19/dr-sarah-e-hill-how-pill-influences-womens-brains
======
KaiserPro
Its not just oral contraceptives, Its anything that increases progesterone
will do the same thing.(as thats the hormone being discussed)

There is the injection,
[[https://www.nhs.uk/conditions/contraception/contraceptive-
in...](https://www.nhs.uk/conditions/contraception/contraceptive-injection)]
and the implant [[https://www.nhs.uk/conditions/contraception/contraceptive-
im...](https://www.nhs.uk/conditions/contraception/contraceptive-implant/)]

both of those work roughly in the same way. Infact they cause much higher
levels, so the effects may be more pronounced.

For my wife, it causes a perma-period, which is a great contraceptive, but not
in the way it was planned.

In terms of mental side effects: loss of humour. She wouldn't watch comedy, as
its not funny. I knew when it was wearing off because she'd start making jokes
again.

~~~
thrower123
> is a great contraceptive, but not in the way it was planned.

Agreed. My repeated experience has been that something about going on the pill
almost completely extinguishes any interest in sex, so that whatever
prophylactic effects it has are nearly academic...

------
NateEag
I still have hopes that someday Vasalgel will make it to clinical trials in
the US:

[https://www.parsemus.org/projects/vasalgel/](https://www.parsemus.org/projects/vasalgel/)

It's a one-application, reversible male contraceptive. "Application" is
surgical, but not an involved one.

If it ever makes it to the market, it seems like a much simpler, safer
intervention, conceptually. Disclaimer: non-medical programmer, so I have no
genuinely useful insights into this subject. Just a layperson making guesses.

~~~
ThrustVectoring
Immersing the testicles in 116 F water for 45 minutes a day for three weeks is
significantly cheaper, and gives an undetectable sperm count for 6 months.
It's honestly likely the best avenue for male birth control, the only problem
is that it's impossible for a corporation to monetize so it's unlikely to get
any sort of traction.

~~~
untog
Something that involves 45 minutes of your time every day for three weeks,
every six months... I don’t know if I would describe that as “the best
avenue”. It’s not as if it’s something I can do while sat as my desk at work.

~~~
analognoise
You need more accommodating coworkers. If you can't take your testicles out
and dip them into nearly-scalding water at your desk in the open-plan office,
you need to do some trust falls at the next morale event.

~~~
untog
"How _dare_ you disrespect my reproductive autonomy!"

------
neom
Almost every woman I have ever dated has told me that they hate the pill and
believe it seriously fucks with their head. I've never encouraged anyone to
use that method, and I wish we had better male options.

~~~
stinos
Same here. And every women I know who stopped taking the pill would rave on
how good it made them feel in general, and specific things like an increased
sex drive. I was there when my current GF stopped taking the pill and can
attest to that: an improvement on many fronts and seemingly no disadvantages.
But yeah, billion dollar industry, people are used to it, convenient, ... so I
don't see this getting better soon.

------
lazide
Why doesn't Paragard (non-hormonal copper IUD) not come up in these threads?
It doesn't have any hormones, and is usually a better experience - and is far
more effective. For some reason, at least in the US however it seems like
almost no one has heard of it?

Pushing the pill with all it's side-effects and low efficacy frankly seems
borderline malpractice?

~~~
adsfafsd
I've had it, twice. Both times it just disappeared from my body and I ended up
unwantedly preggo. I never want to go through abortion again.

------
deboflo
I noticed that my girlfriend and I stopped having arguments after she got off
the pill. That was over a year ago. She’s much more relaxed. I also got the
snip.

------
tgv
In my experience, doctors, also GPs, are aware of effects on mood. In fact, my
SO didn't start taking the pill until it was recommended for precisely those
reasons during the (peri)menopause. There is a great deal of uncertainty about
which pill will work, if any, but that's hardly surprising, as we have so
little knowledge about the brain.

------
newnewpdro
My ex I lived with for a decade would go on and off the pill mostly to deal
with her adult acne in the first few years we were together, in our mid 20s.

Every time she got back on it we'd have insane arguments and go through crazy
volatile periods where the relationship was crumbling. She'd get off it, and
everything would magically stabilize again.

Her eventual decision to stay permanently off it was one of the best things
that ever happened to our relationship.

------
JimboOmega
As a transgender woman, I can assure you that hormone levels (estradiol in
particular) do affect mood. If I forget to take my medication I will get a
migraine, for instance, and this is a pattern also observed in cisgender
women.

But what levels are ideal, what is good and bad, etc, is not the least bit
clear cut for anybody.

~~~
grumblepeet
Same here. Loss of estradiol makes me feel like I'm falling off a cliff. There
was a shortage of estradiol here in the UK lately (due to Brexit mostly) and I
ran out for a few days and went into a panic. The last time I ran out
previously was a bad time for me, but who can accurately say that the lack of
estradiol was entirely to blame?

I'm an artist well as techie, and my artwork has completely changed since
starting estradiol 4 years ago. I used to draw only in pen and ink, always
architectural scenes, black and white, lots of straight lines. Now that
doesn't interest me in the least, and its all watercolours, and curves, and
trees, and people. I am fascinated by people.

I also really enjoy talking now, about anything to anyone. I never ever used
to do this before.

~~~
JimboOmega
It's so hard to untangle hormones from life events.

I transitioned in a way that's somewhat backwards from how people typically do
it these days; I was presenting female or genderqueer pretty much 100% of the
time before I transitioned.

And through that, I found my female side was the one full of color, life,
extroversion, you name it. It wasn't hormones so much as just being me. The
party half of me - who went to bars, clubs, etc, was always female.

It definitely does something, though. Both times I got on hormones (once after
a few weeks break for surgery) I went through a period of weeks-to-months
where I was very zen and in control of my life, though whatever it was, I
gradually adjusted. It's almost impossible to tease out what's life events,
what's hormones, and then what hormones are causing which things. Because E2
and T are coupled (E2 suppresses T, albeit with lag)... which is really
driving what? And never mind P.

Bottom line, biology is too complicated for the very blunt instruments we have
to measure it. We're _really_ winging it, transgender people especially. It's
easy to say things like women live longer and are way more prone to migraines
and depression. But why? Is that from hormones? Are people who have a little
bit more of some hormone just a little bit more likely to be depressed? Or is
the depression an artifact of how culture treats women?

There's no basis for the assumption that cisgender hormone levels are ideal
for transgender people (and even if they were, at what part of the cycle would
be ideal?), but it's kinda all we got to go on.

Hormones are weird, yo.

------
doot42
I think it indicates a problem between the system of science and the
observation of the human mind that it has taken us this long to take the
psychological symptoms seriously. People need to realize that science is not
equipped to discern much of the truth about psychology at this time, we simply
do not have enough accurate data collection methods yet.

~~~
concordDance
I suspect this was a bigger factor:

> The best defence against the sexist notion that women’s hormones make them
> less rational than men seemed to be to deny hormonal involvement in the
> brain.

Getting funding for something that has very unfashionable implications is
hard. Arguing against the pill (which is what pointing out issues with it can
be seen as) can be taken as arguing against women's lib unless you have
something nicely objective (like blood clots) to point at.

~~~
jaynetics
This seems a bit speculative. Research is carried out all over the world, and
at least when it comes to health many countries aren't as hysterical (excuse
the pun) as the US about political correctness.

I agree somewhat with the GP, though. There are ways to discern mental issues,
but very few physicians will ask patients about their mood unless problems are
really obvious.

------
senectus1
My wife used oral contraception prior to us deciding to have children because
it helped her manage period pain symptoms.

Now after children has had a semi perm (merina) contraceptive installed to
manage the damage done by having children. Without it she would "bleed" almost
all month long.

Its way past the time that the conservative sticky beaks made their uninformed
the only message that law makers hear. Contraceptives are NOT just for
stopping/managing baby production, they're also about saving lives and
improving quality of life.

~~~
coredog64
Oral contraceptives were illegal in Ireland at one point, but you could get a
prescription for other medical uses such as treatment for irregular
menstruation. Allegedly, at that time, Ireland had Europe’s highest rate of
irregular periods.

------
wavefunction
I've had this discussion with at least a few of the women I've shared some
intimacy with. At least one was hesitant to take chemical birth-control over
physical prophylaxis due to how it made her feel and act.

~~~
senectus1
its worth noting that its not just one pill. there are several different
chemical variations to "the pill" some work better or differently than others,
it may take some trial and error before one that does the job and doesn't have
negative side effect is found for that person.

------
spinach
I had no idea before I took the pill that depression was even a side-effect
but within a few weeks after taking it the effect was obvious. I already had
depression but it was clearly much worse on the pill and then I found it was
indeed an effect of the pill. I don't know how so many women take the pill
when the side-effects are so awful.

------
repomies691
When my partner was on pills, she had way more mood swings than after she
stopped taking them. I would say our life changed quite drastically to better
after she stopped taking birth control pills.

------
indigochill
That's interesting. My ex mentioned she felt a lot better very quickly after
getting off the pill. There were a lot of confounding factors and as with most
medical things different people's responses differ, but it's still interesting
to read this support of that observation.

------
lurquer
Of course pills screw up women's brains. But, it's a small price to pay;
nearly all other methods make sex slightly less enjoyable for men. A
satisfying orgasm without the concern of paying child support is definitely
worth women doubling their suicide rate (per the article) and suffering mood
disorders.

I jest. Sort of. The solution, of course, is simple: find a woman, get
married, and have kids. It's fairly trivial -- in the vast majority of cases
-- to plan pregnancies using the rhythm method. It's not rocket science. A
couple who lives together and is the least bit attuned to their mate's bodies
and mood can tell when the woman is fertile. Doesn't work for casual sex with
semi-strangers though.

~~~
thatfrenchguy
Or you know IUDs. Not everyone needs to be stuck in the « make 6x as many
children because we don’t have birth control » mindset. All the « calendar-
based » «birth control » have terrible success rate.

~~~
lurquer
The calendar method fails for the same reason condoms 'fail' and coitus
interruptus 'fails'....

People don't actually use the method properly.

I agree with you... if you expect a couple of dumbasses to refrain 100% from
allowing semen into the vagina for a week or so during the cycle, you'll end
up with a baby.

But, for the typical Hacker News user in a monogamous relationship -- that is,
a person with an above-average IQ -- the rhythm method is perfectly adequate.

It may sound conceited and pretentious, but keep in mind that birth control
was invented for idiots who are too simple-minded to pay attention to the
absurdly regular cycles that govern ovulation. When you read statistics about
the 'failure' rates for certain forms a birth control, keep in mind the
sample-size includes folks who literally need directions on how to wear a
condom...

In short, when we discuss birth-control, let us -- the non-dumbasses -- be
aware that what we are really talking about are methods to keep stupid people
from having so many babies. I don't know you from adam, but by virtue of you
hanging out here, I would expect you and your mate will have precisely the
number of kids your were planning to have, without the use of pills, condoms,
or vasectomies. Maybe there will be a 'woops' baby once during a long
marriage. But, who cares? It's not the end of the world to knock up one's wife
by accident. At least not worth the downsides of the Pill in most cases.

Once again, if the intent is to have casual sex with many people throughout
one's life, then by all means you'll need birth control... even if you're
smart. And, apparently, society has decided it is preferable to convince women
to take mind-altering pills so that there will be a steady supply of chicks we
can bang without fear of consequences, to doing what most human males have
done throughout history; namely, aspire to monogamy.

------
basicplus2
One of the best contraception methods of have ever heard of is Vas-occlusive
contraception

Where a tiny blob of something is inserted and hardens inside the vas
deferens, permanently blocking the sperms exit.

Years later when you want children a tiny incision is made in the vas and the
blockage is popped out.

no messing with anybodys hormones.

Vas-occlusive contraception methods are expected to have similar side effects
to vasectomy, such as formation of sperm antibodies, though with lower rates.

But... i have never seen it offered in the Western World as an option.

[https://en.m.wikipedia.org/wiki/Vas-
occlusive_contraception](https://en.m.wikipedia.org/wiki/Vas-
occlusive_contraception)

~~~
big_chungus
It may well be a demand-side issue. I'm not sure how many guys want to get
surgery, however minor, to do that (especially given the sensitivity of the
region.) Even if it's safe, there's a somewhat visceral impulse to shrink away
at the thought of getting cut open down there. The rate of vasectomies is half
that of Canada or England, so it seems a lot of Americans agree and don't want
that. I certainly wouldn't.

~~~
leetcrew
it's worth noting that vasalgel is a slightly less invasive procedure than a
vasectomy, although it is an injection which is certainly a little scary.

I, an american man, feel completely the opposite way. all the women I've dated
have experienced problems with hormonal birth control, ranging from mood
disorders to severe bleeding and one also had severe complications from a non-
hormonal IUD. I don't know if this is a representative sample, but I
personally feel that it's unfair to expect your partner to bear this burden
just to avoid using condoms. I would be very willing to endure a couple weeks
recovery time for an effective male contraceptive. the only things stopping me
from getting a vasectomy are cost (I have a high-deductible policy) and the
fact that I am young and might want children a decade or two from now.

~~~
big_chungus
Why is it any more fair for someone's wife to expect him to get his genitals
sliced open than for her to take a pill? That's a decision spouses must make.
But my contention was that it was a broad statistical figure, not that it
applied directly to you. The demographics of HN readership are certainly
different from the demographics of broader America.

------
matheusmoreira
Which scientific articles does this book reference?

~~~
tomhoward
At the very least, the ones linked in the article's text:

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658328/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658328/)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592309/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592309/)

[https://www.ncbi.nlm.nih.gov/pubmed/23528282](https://www.ncbi.nlm.nih.gov/pubmed/23528282)

[https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...](https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2552796)

[https://www.ncbi.nlm.nih.gov/pubmed/29145752](https://www.ncbi.nlm.nih.gov/pubmed/29145752)

[https://www.sciencedirect.com/science/article/pii/S002839080...](https://www.sciencedirect.com/science/article/pii/S0028390801001873)

------
diverboy1988
Despite how effective hormonal contraceptives are, women have to take them
everyday - in case they have intercourse and are at risk of pregnancy not WHEN
they have intercourse and are at risk of getting pregnant.

YourChoice Therapeutics is making a non-hormonal vaginal lubricant that women
could use just before having sex that's more effective than condoms. We hope
this significantly decreases women's reliance on hormonal contraceptives.

~~~
tdburn
How far along in the approval process is your gel? Is it similar to Evogel?

