Cities without landmarks
Niagara Falls, U.S./Canada
When it was first FDA approved in the early 1960s, the birth control pill, like most popularly ingested substances of the era, carried a relatively high risk of stopping your heart. It was called Enovid and the problem was its extreme concentration of estrogen. Concerned, researchers and the pharmaceutical companies who pay them set out to formulate a new, low-estrogen contraceptive chemical, and in 2000, Yasmin was born.
Since then, the Yasmin family’s medical track record has been a frenzied, mercurial story of bliss and disaster, peppered with alarmist side effects and miraculous fountain-of-youth-iness. Some years, banner headlines announce the pill’s cancer-thwarting powers. Other years, we ‘re told we’re throwing tiny, pink grenades into our arteries. In light of this month’s headline-making lawsuit against Yasmin by a 27-year-old stroke victim, we encourage you to step back from the hysteria of the moment to see a chronology of whiplash-inducing mixed messages that haunt many of us at the medicine cabinet every night.
Scientists at Berlex Laboratories formulate a new synthetic progestin called drospirenone. It’s hailed as a “third generation” oral contraceptive that “has the potential to reduce body weight, blood pressure” and “has positive effects on weight and lipid levels,” all while relieving “menstrually related symptoms.” All the Berlex scientists do super-exploding fist-bumps and shout, “Huzzah!” several times in unison. [Ed. note: Unverified]
The FDA approves Yasmin, the world’s first drospirenone and ethinyl estradiol combination birth control pill. The Journal of the American Society for Reproductive Medicine publishes a study saying that the Yasmin cocktail does everything the Berlex study purported, and it gives women lighter, shorter and less painful periods. Ladies rejoice.
Researchers from Department of Dermatology at the University Medical Center Utrecht, Netherlands find that Yasmin treats and prevents serious acne. Dermatologists from the University of Toronto publish a paper in the American Journal of Clinical Dermatology also demonstrating Yasmin’s acne-fighting tendency.
A team of endocrinologists from the Klinikum Benjamin Franklin, Freie Universität Berlin verify Yasmin’s weight-loss connection. It is now sound medical consensus that Yasmin will make you super pretty.
Stop prancing. After five young and otherwise healthy Dutch women die of pulmonary embolisms after taking Yasmin for a short amount of time, a team of researchers in the Netherlands led by Dr. Kees van Grootheest, who is not a sectional sofa, published a paper in the British Journal of Medicine titled “Thromboembolism associated with the new contraceptive Yasmin.” Again, this paper looked at five (not five thousand) women. Later that year, scientists from Spain published a similarly-themed paper called “Transient ischaemic attack [a terrifying stroke] associated with the new contraceptive Yasmin.”
“Sudden death” is added to Yasmin’s side effects, and everyone starts PMS-ing over it.
Good news! A Bayer-sponsored Europe-wide study found that there was no statistically significant risk of stroke or cardiovascularly-related death among women who took drospirenone-containing birth control pills as compared to women who took previous generations of progestin-containing birth control pills. On the one hand, Bayer is looking to acquire Yasmin from Berlex’s parent company (which they finally do in 2006). On the other hand, well, sure, maybe that raises some conflict-of-interest questions — but still, it’s science, with statistics and everything.
Good news that isn’t tainted by corporate interests! A team of scientists from from the Department of Epidemiology at the University of Pittsburgh (and funded by grants from the National Cancer Institute) find that all androgenic and nonandrogenic progestin-containing birth control pills yield “a similar and significant reduction in ovarian cancer risk.”
Yaz, which is a variant of Yasmin containing an even lower dose of the estrogen component, receives FDA approval. Bayer acquires Berlex, and with it, the whole Yasmin family. The drospirenone line will go on to be the nation’s top-selling oral contraception, contributing significantly to Bayer’s $1.58 billion in sales the following fiscal year. Also prompting an uptick in Yaz prescriptions is news that women with renal problems, who had been previously cautioned against progestin drugs, would be safe taking Yasmin because “drospirenone has no significant effect on serum potassium levels in patients with mild to moderate renal insufficiency.”
Infuriatingly blasé scientists from the Hormones and Cancer Research Unit of the Institut de Puriculture et de Prinatalogie in Paris publish an article in the journal Gynecological Endocrinology explaining that some studies indicate that progestin-based birth control caused an increase in breast cancer incidence, while others show no difference, and still others produce a significant decrease. They recommend, but don’t conduct, “further clinical trials.”
The FDA — and Broadsheet! — call out Yaz’s advertisers for misleading the public by implying that Yaz combats premenstrual syndrome. Unimportantly to Yaz, PMS is different, and far less severe than premenstrual dysphoric disorder. Relatedly, the Yasmin franchise netted about $1.8 billion in 2008.
In legitimate news, that year, researchers from Oxford University and the American Cancer Society published The Greatest Study of Our Time, which took together four decades-worth of studies on oral contraception and found, simply, beautifully, “that the longer a woman took birth control pills, the lower her risk of ovarian cancer.”
A spectrum of bad news. Dutch scientists demonstrate a positive, staggering correlation between the amount of second-generation estrogen compounds in a birth control pill and the likelihood of killer blood clots, or venous thrombosis. Terrifyingly, the use of oral contraceptives containing levonorgestrel (the main component of most morning-after pills including Plan B), was associated with a 6.3 fold increase in strokes versus drospirenone users. So, while Yasmin and Yaz were the usual suspects with regards to embolisms, it turns out, the alternatives offer up a greater risk of clotting. Before you flush your pills down the nearest toilet – which, as Nicholas Kristof is quick to remind us, mutates and kills frogs – note that the sample sizes in testing both classes of oral contraception are very, very small.
Before you wallow in abject terror and doubt at this evening’s dosing time, consider the alternative. According to an Amnesty International report released this March, the incidence deaths from pregnancy and childbirth in the US have doubled since 1990, and roughly one-third of pregnant women in the U.S. suffer from serious complications. Now, here is a video of kittens.
Niagara Falls, U.S./Canada
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