Beware, it’s a bitter pill we swallow

They’ve done it again. For the third time, scientists have found evidence that the contraceptive pill may be inhibiting women’s capacity to conceive in more ways than one. Worse, it may be playing havoc with their love lives.

The most recent findings, published in this month’s Proceedings of the Royal Society, show that women who take the pill have an altered sense of smell. Specifically, they delight in the scents of men who have a similar, rather than a complimentary, immune system.

The finding follows two other studies, both done in the 1990s, that suggested oral contraception may disrupt a woman’s pheromone detection system.

The implications of such disruption are vast. Pheromones play an important role in the normal human mating process. If pill-taking women are drawn to what are, genetically speaking, the “wrong” men, the results could include increased difficulties conceiving, higher rates of miscarriage, longer intervals between pregnancies and-when at last they arrive-genetically compromised offspring. Not to mention, given the role smell plays in maintaining partnerships, more divorces.

Women may respond to such research findings with the same sense of dismay, and the same feelings of betrayal, as they did to the news that those ingesting combination HRT pills to prevent heart disease were not only wasting their time, but putting their overall health at risk.

Such a response would be a good thing if it leads Australian women to take a more active and skeptical role in decisions about what they put in their bodies. The kind of attitude that would lead them to reject-once and for all-the belief that pharmaceuticals interventions wouldn’t be licensed, sold or recommended unless they were “safe.”

The truth is far trickier. According to science journalist Ray Moynihan, the undisputed expert on this matter, “a significant proportion of what many doctors do for their patients is not based on good scientific evidence.”

There are vast problems with the information on which critical decisions about our health are currently based. They include the fact that, even where data exists, it often does not come from the double-blind placebo-controlled trials that are the gold standard for producing valid and reliable knowledge about what is safe and effective.

Indeed, even when studies have been done, and done properly, their capacity to answer the question most women want to know-namely “is it safe for me to use in the long-term”-may be limited. This is because the expense of conducting good research means most studies only look at short-term side-effects and fail to assemble large and diverse enough samples to ensure rare problems-only those impacting on women or blacks or other sub-groups-will be uncovered.

Finally, we need to remember that for the most part, researchers need to look for a problem to find it. Even a gold standard trial with a large and diverse sample that follows participants for many years will not uncover cancer as a long-term side effect of treatment if heart trouble is the only complication they are measuring.

So what should women do? When it comes to pharmaceuticals, a common-sense approach would be to ingest and insert as little as possible. Where something must be taken, it seems wise to choose the least invasive, most reversible and lowest risk option, and to use it for the shortest period possible.

And if you are currently in the market for a partner with whom to have children? It couldn’t hurt to come off the pill, and have a good sniff around.

Publication history

Beware, it's a bitter pill we swallow  Sunday Sun-Herald (Sydney)