March 26, 2003

DEAR ANDREA: Before you endorse IUDs or Depo-Provera, you may be interested to know that many, many women have suffered severe, irreversible injuries causing infertility, mutilation, psychological injury, and other "adverse events," including death, by using them. Women are targeted by pharmaceutical and medical-device manufacturers many, many times more often than men and are injured exponentially more often. Just because something is on the market does not mean it is safe. I'm sure you wouldn't want to get an e-mail from the husband of someone who heeded your advice and wound up in the hospital.

Stick to sex advice, not product endorsement.

Love, Aware Woman

Dear Woman: I've always wanted to ask this, so thanks for the opportunity: Why do you do this? Why do so many people, especially progressive, well-meaning, conscientious, often female people, want so desperately to believe the world is yet more dangerous than it really is? Think about it: I'm writing this on March 19, 2003. U.S. troops are massing on the Iraqi border. By the time you read this, we'll be at war. The alert level is at "orange high," whatever that means. Israeli families are toting their gas masks with them everywhere they go. The world isn't scary enough for you? Why concoct conspiracies where none exist, and why spread your personal panic to innocent readers of this column and who knows who else? You can't be happier this way. I'd suggest, in all seriousness, that you investigate anxiety meds, but no doubt you've already been tipped off to how Big Pharma targets women with happy pills designed to make us tractable and submissive. That way, we'll be ready to roll over and become handmaidens to the theocrats after God's Army wins (or rather steals) the next election. Grow up.

The IUD you have in mind, the Dalkon Shield, has been off the market for a good 30 years now. It did indeed cause infections, pelvic inflammatory disease, and infertility. As a result, the manufacturer, A.H. Robins, was sued out of existence. Other, probably blameless IUDs went out with the Shield, at least in the United States (other IUDs remained popular elsewhere even as they went nearly extinct here). The lawsuits, justified as they were, had a chilling effect on the pharmaceutical companies, keeping them from putting much money into contraceptive research again until fairly recently. Understand that this is a bad thing. New contraceptives are not evidence of a war on women; they are the key to women's emancipation and advancement worldwide. When women have fewer children, they can pull themselves out of poverty, provide for their families, and maybe stay healthy enough to live past 30. I would have thought you already knew all of this, since you claim to be so passionate about women's health.

Because the IUD (a small device installed in the uterus to prevent the implantation of an embryo) is basically a sound idea, and because so many women prefer a birth control method that doesn't require constant attention, it's finally back. The most popular recent arrival, the Mirena, is a combination hormonal-physical method marketed specifically to women who have already had a child. It's safe. It works. It's no more dangerous than childhood vaccinations or snack food manufactured in a facility that may have been used in the processing of peanuts. Or, for that matter, asbestos-loaded tampons or diet sodas that give you lupus. Yes, those last two are urban legends, but so's your thing about legions of women dropping dead or suffering "psychological injury" from using modern contraceptives. I hope you don't believe the pharmaceutical companies target women for injury. That's beyond urban legend and into delusion, and you really ought to get that looked at.

Depo-Provera is the every-three-months progestin shot. It's a powerful drug, and some women detest the side effects, which can be long-lasting. But you don't die from weight gain, moodiness, or light bleeding. Oh, it's injured or killed some people, for sure, but remember that it's been taken by huge numbers of women for 20 or more years – of course there have been some disasters. Haven't you ever noticed that every drug on the market has a list of side effects ending with something like "blindness, seizures, coma, and death"? Don't you take medicine when you need it anyway? You shouldn't, you know. You should take herbs, because if it's all-natural, it can't hurt you.

I don't, in fact, endorse these products. I'm pretty neutral on them, and of course I'm aware that they can be dangerous. Anyone interested in them should see her doctor, not listen to me. Nor would I claim the big pharmaceutical companies are interested only in our health and happiness. It's a cutthroat industry, and the moral standing of some of its members is shaky at best. But they want to sell us drugs; they don't want to kill us. Dead women don't buy Depo.

Love, Andrea