Thursday, September 11, 2003

Seasonale Proves the Earth Is Flat--Part II

As promised, let's take a closer look today at Seasonale: A Eugenicist's Dream, an opinion piece, dated August 8, 2003, from The Washington Dispatch site. I'm not at all familiar with this site, however I did note their prominently displayed motto: "Your Source for Reliable News and Unbridled Opinion".

First, just so we're all clear on what the meaning of "is", is:

Eugenics = The study of hereditary improvement of the human race by controlled selective breeding./ n: the study of methods of improving genetic qualities by selective breeding (especially as applied to human mating).

So, presumably, when eugenicists dream, visions of DNA and selective breeding dance through their heads. This doesn't, however, explain the linkage in the title between Seasonale and eugenics. What's the connection? Seasonale = Eugenics? Seasonale is the main feature in an eugenicist's dream? What?

Seasonale, is a drug intended for period control (menstrual management), not pregnancy control--selective, or otherwise. Period control allows a woman to choose when to have a period and how many periods to have, regardless if she is, or isn't sexually active. Since you can't have eugenics without sex, the question remains: what's the connection between menstrual management and eugenics? Well, maybe if we're patient, somewhere in the article the connection will be revealed to us. So, let's look at the first half of the article today.

The article opens with a straw man set-up:

-- menstrual management is the "latest bit of medical scientific 'progress'"

Actually, menstrual management has been used for over 40 years and is considered the standard of care by the medical community.

-- menstrual management is based on the fact that "It's NOT normal to have a regularly functioning menstrual cycle."

There isn't a single article in any peer reviewed medical journal, nor any record of a competent physician stating that it's not normal to have a regularly functioning menstrual cycle. Even the makers of Seasonale clearly state on their site that:

...monthly periods are normal...

-- and, finally, the way menstrual management works is you "pop a new contraceptive pill called Seasonale, and eliminate menstruation almost entirely."

In reality, menstrual management can be used to skip only one period, like, for example, when you're going on your honeymoon (a once-in-a-lifetime event, hopefully), or it can be used to decrease the number of periods from 13 (one every month) to 4 (one every 3 months), like when you're using Seasonale for an entire year.

Next, medical fact and the article start to diverge:

"Medical 'progress' has already technically abolished menstruation in women who are on the pill...But it appears that the manipulation of women's bodies won't end there."

Medical progress hasn't, technically or otherwise, abolished anything. Women who are on the pill do not have menstrual periods because of the pill's mechanism of action. Also, menstrual management involves manipulation of the pill's hormone regimen, not of the woman's body. And, no, the two are not the same since, in a woman who isn't using the pill, the hormone levels produced by the body are also manipulated (they fluctuate periodically), by the body itself.

The article continues, and so does the break from reality:

"The researchers hired by those who stand to make a good deal of money from Seasonale are already force feeding women the notion that having a monthly period is an unnatural, unhealthy medical disorder that they need relief from."

The manufacturer of a product (Barr Labs, the maker of Seasonale) spends years and millions of dollars, employing hundreds of people and paying millions in taxes in the process, to develop a product and bring it to market. Once the product, the result of its labor, investment, and risk, finally reaches the market, it stands to make money. This is logical and reasonable (unless, of course, you think it's OK to walk into the corner bagel store, grab some bagels, and walk out without paying, or if you think Barr Labs' business model should be to sell their products for less than the cost of production, to insure that they do, in fact, lose money). At the same time, all this is also completely irrelevant when it comes to evaluating the quality of information women get from researchers. The researchers' information is either valid, or not, based on scientific facts, not based on their employment history.

As to the researchers "...force feeding women..."--I have yet to see any reports on the hoards of menacing, lab-coated researchers accosting women in the streets, or breaking into their homes and subjecting them to PowerPoint presentations. Not to mention the fact that no researcher involved with Seasonale has stated that having a monthly period is an "unhealthy medical disorder". And the "unnatural" trick is just that, a trick. In medicine, unnatural simply means not seen in nature (it's unnatural for humans to fly unaided--you know, seeing how we have no wings and all). The term doesn't have a negative, or positive, connotation: it's neither unhealthy that humans don't have wings, nor is it healthy.

Moving on, this is just plain silly:

"The medical 'evidence' they base this opinion on?"

OK, repeat after me: using scare quotes for the word evidence is nonsensical. Evidence, especially medical evidence, is either valid, or invalid. If you think the evidence is caca, great. Use facts to refute it or have a hissy fit--whatever. Just don't use quotation marks--they are meaningless in this context.

And the silliness continues:

"That cavewomen and members of primitive tribal cultures did not menstruate as often as we American women. This somehow makes us abnormal. I can't help but wonder at what point we began basing our modern health norms on what was normal for cavewomen. And I wasn't aware that cavewomen kept detailed records of their menstrual cycles."

The reason we have to look at cavewomen and women of primitive tribes is because humans are social animals. This means a lot of our traits (how often we have a period, our weight, our intellect, etc.) are influenced partly by nature and partly by nurture (societal/cultural factors). In order to determine what's normal in nature (what nature intended), we have to separate nature from nurture. The only way to eliminate nurture's influence is to look at women living in the wild, so to speak--hence cavewomen and primitive tribes. This is called the scientific method of study, and it's the reason we study cavewomen. No strange desire to start a retro-cave trend is involved (as if any sane person would yearn for the good old...cave dwelling).

Oh, and one more thing. The fact that we menstruate more than the famed cavewomen means our menstrual pattern is not what nature intended. In other words, the cavewoman's period frequency is determined only by nature, which makes it the natural pattern. In contrast, our period's frequency is influenced by both nature and nurture (time at first period, life expectancy, infant mortality, breastfeeding, and the ability to choose infertility). This dual influence doesn't mean us, modern women are "abnormal". All it means is that we have a period pattern which isn't seen in nature.

Here we go again:

"Medical authorities are using this overwhelming scientific 'discovery' to convince women that they will be healthier if they take the pill. They are enamored with reminding women that with menstruation comes a plethora of dangerous side effects: headaches, bloating, moodiness, cramps, and the worse culprit of all, inconvenience."

One more time: using scare quotes, for the word discovery this time, is nonsensical. Something either is, or isn't a scientific discovery. If you don't think it's a discovery, use facts to refute the evidence or throw a temper tantrum. Either way, stay away from, you know...quotation marks. Also, using at least one actual fact sure would help a lot. No authorities, medical or otherwise, are using the fact that cavewomen had less periods to convince women of anything. The reason women are healthier if they take the pill is because the pill is a medication which:

1. treats a variety of medical problems (migraine headaches, heavy bleeding, ovarian or breast cysts, etc.), in women who suffer from period-related health problems

and

2. considerably lowers the risk of cancer (ovarian, uterine), protects against Pelvic Inflammatory Disease, or PID (an infection of the upper part of a woman's reproductive tract), etc., in women who don't experience any period-related problems

And how exactly does the fact that medical authorities are doing their duty, by educating women about the side effects of the menstrual period, demonstrate that said authorities are "enamored" (of what exactly, it's not entirely clear)? It is one of the basic principles of the Hippocratic Oath that a physician: first has to watch (to learn), second has to do (to practice), and third has to teach (to educate). Should we perhaps ask medical authorities to stop reminding us about the side effects of pregnancy, or AIDS, or heart diseases, least they appear "enamored"?

Also, what medical authority, ever, anywhere has stated that the worst side effect associated with the menstrual period is "inconvenience"? If this matter wasn't so serious--period-related health problems can, and do kill women--the fabrications in this article would be mildly amusing. Let's look at this "inconvenience" issue for a moment. Clearly, this aspect of the period can be highly subjective: your slightly annoying period cramps and week and a half of bleeding can be your best friend's week and a half spent in the middle of the desert in Iraq, fighting the enemy while cramping and worrying about where to get a tampon. So, just because the period is less inconvenient for some women, is no justification to be patronizing and dismissive of the women who do find the period inconvenient.

Finally, remember how I said the fantasies which pass as facts in this article would be mildly amusing, were it not for the serious matter of period-related health problems? Here's the last example for today:

"One article I read even stated that the rare side effect of anemia (iron-poor blood) is one of the world's worst medical maladies. I would have voted for something like cancer or heart disease."

Let's go to...reality, and check the facts:

-- The World Health Organization considers iron deficiency the number one nutritional disorder in the world . It affects more than 30% of the world's population.

-- Just in the U.S. alone 7.8 million teenage girls and women suffer from iron deficiency, of which 3.3 million have a more severe form called iron deficiency anemia.

Source: The Journal of the American Medical Association, 1997;277(12):973-976. (sorry, couldn’t find a link to this article)

-- Iron deficiency anaemia affects over 2 billion people, particularly women of reproductive age and pre-school children.

-- Iron deficiency is the most prevalent single deficiency state on a worldwide basis. It is important economically because it diminishes the capability of individuals who are affected to perform physical labor, and it diminishes both growth and learning in children.

-- There are several kinds of anemia produced by a variety of underlying causes, but the most common and most severe type of anemia, iron-deficiency anemia (IDA). Just as the name implies, this form of anemia is due to insufficient iron. In the United States, 20% of all women of childbearing age have iron-deficiency anemia, compared with only 2% of adult men. The principal cause of iron-deficiency anemia in premenopausal women is blood lost during menses.

Before I go, a final note. Perhaps I went a bit overboard with the number of examples, but this can not be emphasized strongly enough: just because one writes an opinion piece, doesn't mean that reality and facts can be ignored. For example, if you think the millions and millions of women who suffer from iron deficiency anemia are insignificant and deserve to be mocked, just grand! This is a free country and you are entitle to your opinion. But what you're not entitled to is pretending reality doesn't exists, and/or distorting said reality.

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