Thursday, February 16, 2012

Magic Pills of Darkness

New Hampshire State Rep. Jeanine Notter (R) has a novel argument for why health insurance shouldn't cover birth control: It causes prostate cancer.

In case we're unclear: Birth control? Almost exclusively taken by women (e.g., the pill, IUDs, Nuvaring, etc.). Prostate cancer? Only occur in men, because men, unlike women, have prostates. So unless those be some magic pills women be popping, the odds that birth control causes prostate cancer is very, very slim.


PG said...

The criticism is a little cheap -- Notter pretty clearly meant that the presence of the hormones in the Pill has been correlated with increased risk of prostate cancer in men. The possibility that males' exposure to the synthetic hormones in the Pill can cause disease or deformity was raised by Nicholas Kristof repeatedly, and he didn't get mocked (although he was seen as an alarmist). It would be more appropriate to question whether Notter has ever exhibited any concern about the rampant overuse of hormones and other chemicals in modern agriculture, which probably are entering men's bodies to a much greater extent than anything from the Pill.

(I don't know if the study published in the BMJ successfully factored out the extent to which use of oral contraceptives would correlate with many other possible environmental contributors to increased prostate rates, as well as correlating with a medically-advanced culture in which men get more prostate screenings -- often "over-screened," inasmuch as many prostate abnormalities are benign.)

Sarah said...

To add a little more context to Nother's proposal: the issue is not that the act of women taking BC will result in prostate cancer in men. The issue is that estrogen and other pharmaceutical products/metabolites are not adequately removed during waste-water treatment, resulting in increased exposure to estrogen, etc for pretty much everyone.

Piggybacking off of PG's parenthetical remark, the BMJ Open article is actually pretty inconclusive about all of those issues. It takes into account very few data sets (GDP to look at how likely it is that men get PSA screenings, incidences of prostate cancer, and the use of different contraceptives, divided into their different categories). There are a number of conclusions one can make from that paper, the best one being that no well-substantiated conclusions can be drawn.

Indeed, there were several reviews/comments to that effect, all of which can be accessed from the article as cited by PG. The comments suggest that the original paper did not take into account well-known contributory factors that would be increased in countries where oral BC intake was higher; they are well-worth reading. What I would be very interested in, you know, if I had the time, would be to go through the references cited by the original paper and look at some of their findings re: estrogen.

All of that said, I do think that Nother's proposal is ridiculous, and another thinly veiled attack on women's reproductive rights. So she's a nutcase, but not wholly wrong to be concerned about the effects of pharmaceutical waste in general.