The Science of Natural Family Planning

Presented by Scott & Laura SchulzeThe Science BehindHormonal ContraceptivesPro-Life Symposium & Technology SymposiumSaturday, September 19, 2009Dayton Engineers ClubDayton, OH1OverviewHow the Body Naturally WorksHistory of Hormonal ContraceptivesHow Contraception Unnaturally worksWhat does Planned Parenthood say about Hormonal ContraceptivesHealthy Alternatives to Contraceptives

7OverviewHow the Body Naturally WorksHistory of Hormonal ContraceptivesHow Contraception Unnaturally worksPlanned Parenthood & Hormonal ContraceptivesHealthy Alternatives to Contraceptives

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The Female Reproductive System4

EndometriumLuteininzing Hormone (LH)Pituitary GlandFollicle-Stimulating Hormone (FSH)OvariesEstrogenCervixPituitary GlandOvulationProgesterone5How the Body Naturally WorksThree things necessary for Conception of baby (embryo)SpermEggCervical MucusHelps healthy sperm reach eggImplantation onto Uterine Wall is necessary for baby (embryo) to survive

History of Hormonal Contraceptives1550 BC Egyptian Papyrus mentions the use of Crocodile Dung before intercourse

Ancient Arabian documents mention the use of Elephant Dung mixed with Honey

Incas, Myans, Aztecs used roots of plants like mandragora

Also used in ancient times were:Seeds of Queen Annes Lace, Wild Carrot, Pennyroyal, Artemisia, Myrrh, Rue, Pomegranate Seeds

History of Hormonal Contraceptives7th Century BC the Silphion Plant from CyreneSilphion is a Giant Fennel plantContraceptive & AbortifacientOnly grew in a 125 mile x 30 mile stretch of LibyaOver harvesting led to increase in value worth its weight in silverExtinct by 2nd Centruy AD

Asafoetida (used in Worcestershire Sauce)Cheaper but less expensive alternative to Silphion

History of Hormonal ContraceptivesSilphion Plant from Cyrene on an ancient coin.The plant created a huge economic boost for CyreneThe usage of the Silphion is implied

History of Hormonal Contraceptives1873 Congress passes Comstock Law birth control illegal1914 Eugenics advocate Margaret Sanger coins term birth control in her journal The Woman Rebel, flees country to avoid lawsuits1918 The Crane Decision allows birth control for therapeutic purposes

1921 Margaret Sanger forms American Birth Control League (Planned Parenthood Federation of America)

History of Hormonal Contraceptives1921 Haberlandt showed that transplantation of ovaries of pregnant rabbits into fertile female rabbits suppressed their ovulation and fertility1944 The effective hormone was found to be progesterone1936 Margaret Sanger orchestrates court battle which results in legitimizing birth control and official recognition by AMA1938 Inhoffen & Hohlweg synthesized Ethinyl-OestradiolHistory of Hormonal Contraceptives1941 Russel Marker makes Synthetic Progesterone with Mexican wild yams (cabeza de negro)1951 Margaret Sanger has 200 birth control clinics1951 Margaret Sanger asks Dr Greg Pincus to create a contraceptive pill1951/1954 Carl Djerassi creates pill form of synthetic progesterone1952 Frank Colton develops a pill form of synthetic progesterone1953 Margaret Sanger secures funding for Dr Pincus to continue development of a contraceptive pill

History of Hormonal Contraceptives1954 Dr Pincus & Dr John Rock begin first human trials of their pill (high dose) in Boston under guise of a fertility study due to anti-birth control laws in USThe study uses 21 days of pill + 7 days off to allow for menstruation so the pill will seem natural1955 Conclusive results of study announced1956 Clinical testing of Enovid begin in San Juan, Peurto Rico due to anti-birth control laws in US. Pills made by G.D. Searle3 Women died + 17% had side effects but no action taken

History of Hormonal Contraceptives1957 Enovid submitted to FDA for menstrual disorders (GD Searle)1959 Dwight Eisenhower Birth Control is not our (govt.) business1960 Enovid submitted to FDA as a contraceptive (what is was actually developed for)

First drug in history to be given to a healthy person for long-term use 1960 Enovid approved by FDA as a contraceptive

History of Hormonal Contraceptives1961 Anovlar First European oral contraceptive introduced1962 G.D. Searle (Enovid) receives reports of dangerous side effects11 Deaths, Blood Clots, Heart Attacks no action takenComplaints dismisses as exaggeratedConsidered the price women had to pay for a contraceptive1962 Ortho Novum hits US market. Other pills follow1964 Lyndon B. Johnson pushes legislation for federal support of birth control for the poor

History of Hormonal Contraceptives1965 Griswold v. Connecticut US Supreme Court rules prohibition of birth control sales is violation of right to privacy1967 NAACP accuses Planned Parenthood of racial genocide1969 A Doctors Case Against the Pill (Barbara Seaman) published1970 After Congressional hearings, information on side effects of the pill are included in the packaging1972 Eisenstadt v. Baird US Supreme Court rules against the prohibition of birth control sales to single women 1974 Govt. supports Birth Control clinics in 2,379 counties (77%)1980s Low dose birth control pills introduced. Original high dose pills removed from marketHistory of Hormonal Contraceptives1990 FDA approved Norplant2002 Norplant removed from US market2002 FDA approved Norplant-21999 FDA approved Plan B (Emergency Contraception)2000 FDA approved RU-486 (Abortion Pill)2000 FDA approved Mirena2001 FDA approved Nuva-Ring2001 FDA approved Ortho Evra Patch2004 FDA approved Depo-Provera2007 FDA approved LybrelOverviewHow the Body Naturally WorksHistory of Hormonal ContraceptivesHow Contraception Unnaturally worksWhat does Planned Parenthood say about Hormonal ContraceptivesHealthy Alternatives to Contraceptives

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Birth Control PillsThree Kinds: Mini-pill progestin only Combination progesterone and estrogen Seasonale longer cyclingUsed by 10 million women in the United States, 4 million are 25 years old and younger.The birth control pill is also known as an oral contraceptive. It is a pill taken by mouth daily.There are several types of birth control pills on the market, but they basically break down into two groups: The progestin-only mini-pill and the combination pills.

The progestin-only mini-pill uses only one artificial hormone, called progestin, which is a steroid that has an effect similar to natural progesterone.

The combination type contains two artificial steroids that mimic the effects of natural estrogen and natural progesterone. Some pills work in a monophasic way, keeping the dosage of hormones the same throughout the pill cycle. Others work in a biphasic or triphasic capacity which alters the dosage of artificial hormones tow or three times, respectively, through the cycle of pills, attempting to produce fluctuations similar to what a fertile woman would undergo naturally.

The Seasonale is referred to as an extended-cycle birth control pill. The only difference between Seasonale and regular combination birth control pill is that Seasonale packets contain 91 pills, instead of 28. The effect is that the reproductive process is suppressed for three months instead of one.4- Pronged Attack on a Womans Fertility

1) Prevents ovulation from occurring. (Prevents release of egg from ovary.)2) Dries up mucus so that sperm can neither live in vaginal environment nor enter the cervix.3) Changes the lining of the uterus so that the tiny baby boy or girl cannot implant and grow. CHEMICAL ABORTION4) Lowers efficiency with which the fallopian tubes propel eggs from ovaries to uterus.When a woman ovulates, hormones released from the pituitary gland stimulates her ovaries to ripen and release an egg. The combination pill usually interrupts the release of these pituitary hormones resulting suppression of ovulation.

Ovulation is not always suppressed, however. Ovulation occurs in 2% to 10% of cycles of women taking the pill. For example, if 60 million women worldwide are on the low-dose Pill, there would be 1.2 to 6 million ovulations per cycle. This is known as break-through ovulation, and it is even more frequent with the progestin-only pill because it has a weaker effect than the combination pill.

The second way that the Pill works is by drying up the fertile mucus through which sperm swim to meet the egg. The mucus thickens under the influence of a progestin and so impedes sperm migration.

In addition, the progestin component of the combination pill and the progestin-only mini-pill causes the inner lining of the uterus to become thin and shriveled. After an egg is fertilized, it normally implants in the endometrial lining to draw nourishment and sustenance. If the lining is thin and shriveled, it cannot support implantation of the embryo, thereby, causing a chemical abortion. ABORTIFACIENT

It is estimated that for every year that a woman uses the pills, she has at least one early abortion during that year.

One last factor in a womans fertility that may be affected by the Pill is the Fallopian Tubes. Progestins lower the efficiency with which the fallopian tubes propel eggs from the ovaries toward the uterus. This can cause the embryo not to reach the uterus in time to implant successfully, causing another early abortion.

A womans natural fertility requires several systems and organs to coordinate smoothly. The synthetic chemicals in any type of birth control Pill interfere with this coordination, adversely affecting her normal fertility and any accidental conceptions.Common Side Effects of Birth Control Pills Nausea and vomiting (in about 10% of users) Symptoms of PMS: fatigue, breast tenderness, irritability, difficulty concentrating, headaches/migraines, bloating/weight gain/water retention Mood swings, depression Weight loss Loss of sex drive Mid-cycle bleeding Dysmenorrhea (painful menstruation) Amenorrhea (absence of menstruation) Vaginitis and vaginal infections Temporary or permanent infertility when discontinuing PillSome side effects are minor while some may be more sever and call for discontinuing the drug. The side effects listed have been experienced by women on the Pill. Over 30 known side effects of the Pills.More susceptible to HIV b/c the pill weakens the immune system

Mental depression even to the point of suicide and/or suicidal tendencies

There can be mid-cycle bleeding in the first few months, especially in smokers and those who miss their daily dose. Some have reported changes in menstrual flow, and even loss of menstruation.

For some, painful menstruation has been reported to worsen, even though many women take these hormones in an attempt to relieve the problem.

Although some women are given the Pill for irregular cycles, it does nothing to improve the underlying problem causing the irregularity. Often the irregularity returns when the Pill is discontinued, sometimes more severely.

More than a third of all women who start taking the Pill stop within three months because of the side effects so know you're not alone if you've had problems while on the Pill.

Risks Associated with Birth Control Pills Blood clots MI, Stroke, Pulmonary Embolism, Renal Artery Thrombosis & Kidney Damage, Temporary/Permanent Blindness OCP use and obesity: DVT risk increased 10 fold Hispanic women with hx of GDM thrombosis risk WHO Study: Migraines associated with increased risk of cerebral thromboembolism Smokers over age of 35 heart disease, MI, stroke Mild elevation of blood pressure (hypertension) Cancer of the Breasts and CervixNIH: Estrogen is a known human carcinogen. 2002The Pill can have harmful effects on the circulatory system, just as smoking does. A woman who takes the Pill and smokes increases her risk of heart disease by 500%.

Experiments have shown that synthetic estrogens and/or progestins cause womens breast cells to divide more rapkidly, ehich makes them more easily affected by carcinogens. 18 out of 21 research studies done since 1980 on the connection between the pill and breast cancer showed that Pill users have a higher risk of breast cancer than non-users.

An analysis in 1990 of the research up to that time showed that women who used the Pill for 4 or more years before their first full-term pregnancy had a 72% increased risk of developing breast cancer.

Dr. Erik Odeblad scientist did extensive research on the cervix, specifically cervical mucus. He also did studies on effects of oral contraceptives on the cervix. He found that while pregnancy counteracts the normal ageing process and actually has a rejuvenating effect on the cervix so that the cervix of a 33-year-old woman becomes like that of a 20-year-old, the Pill, especially after long-term use has a reverse effect - the cervix of a 33-year-old woman on the Pill becomes like that of a 45-year-old and the cervical canal becomes much narrower.

Contraindication of Birth Control Pills Cannot be used by those with a history of:

Breast cancer Blood clots or risk to develop blood clots Liver disease Kidney disease Unexplained uterine bleeding Smokers over age 35, Melanoma (a type of skin cancer) Those on certain medications (e.g. antibiotics)The birth control pill increases the risk of breast cancer by over 40% if it is taken before a woman delivers her first baby.4 This risk increases by 70% if the Pill is used for four or more years before the womans first child is born.

While pregnancy counteracts the normal ageing process and actually has a rejuvenating effect on the cervix so that the cervix of a 33-year-old woman becomes like that of a 20-year-old, the Pill, especially after long-term use has a reverse effect - the cervix of a 33-year-old woman on the Pill becomes like that of a 45-year-old and the cervical canal becomes much narrower. The new lower dosage gestagen Pills produce similar effects.

Ortho-Evra

Square patch that slowly releases a combination of estrogen and progestin hormones through the skin. Worn for three weeks, off for one week Same mechanism of action, side effects and risks as the pill Can cause rash or skin irritation at site of patch Seems to be less effective than the PillThe PATCH Patch worn on upper arm, buttocks, abdomen or thigh

Prevents ovulation, dries mucus, changes uterine lining (abortifacient)

Nausea, Headache, Depression, Breast Tenderness, Irregular bleeding, abdominal pain, weight gain, irregular bleedingIncreased Risks for Cardiovascular Disease, Venous Thromboembolism, Breast CA, Cervical CASeveral Lawsuits for: Stroke, Pulmonary Embolism, Paralization, Blod Clot resulting in death

FDAs Approval of the Ortho Evra PatchPrior to the FDA approval of 'The Patch' in November 2001, an FDA medical reviewer took exception with the manufacturer's conclusions regarding two cases of blood clots in the lung affecting two, rather young participants in the Ortho Evra clinical trials. (the reviewer) DOES NOT AGREE WITH THE SPONSOR'S [Ortho-McNeil] ABOVE CONCLUSIONS. The two cases of pulmonary embolus, a serious and potentially fatal condition, must be counted as two cases in the group.Despite the warning, the FDA gave Ortho Evra approval.July 2005, an investigation by the Associated Press exposed that 17 of the 23 deaths associated with the use of the Ortho Evra birth control patch appeared to be related to the formation of blood clots.November 2005, four months after the Associated Press report, the FDA fostered a label change to the product, indicating the increased risk of blood clots, and representing double the risk of clots for women taking The Pill.Nuva Ring Thin, transparent, flexible ring inserted into the vagina where it slowly releases estrogen and progestin hormones into the body. Left in for three weeks, out for one week Same mechanism of action, side effects and risks as the pill and patch Can cause vaginal irritation and discharge

The PATCH Patch worn on upper arm, buttocks, abdomen or thigh

Prevents ovulation, dries mucus, changes uterine lining (abortifacient)

Nausea, Headache, Depression, Breast Tenderness, Irregular bleeding, abdominal pain, weight gain, irregular bleedingIncrease risk of cervical and breast cancer

Depo-Provera Most widely-used contraceptive injection in the world that lasts three months. Mechanism of Action

Prevents pregnancy by inhibiting ovulation

Abortifacient: alters normal growth of endometrium and prevents implantation of newly conceived baby Reduced Bone Density Amenorrhea, Headaches, Weight Gain, Low Birth Weights Increased Risks for Breast Cancer and STDs Delayed return in fertility (up to 18 months) Risk of Breast Cancer tripled if use the shot for at least 2 years before age of 25.Major disturbances of menstrual pattern.Prolonged and unpredictable delay in return to fertilityMild deterioration of carbohydrate toleranceSevere and prolonged bleedingDecrease in breast milk productionDepression and reduction in libidoDanger to fetus in event of pregnancy: mainly some masculinizing effects in femalesLoss of calcium from bonesSignificant weight gain

Women who take the shot for 2 years or more before the age of 25 have at least a 190% increased risk of developing breast cancer. Excessive and/or irregular bleeding Temporary or permanent sterility Severe mental depression Depletes calcium storage, placing women at risk for osteoporosis at a much younger age. Worsens a womans cholesterol level

Five or six silicone rods surgically inserted into arm, releasing hormones into the bloodstream and lasting for five years.Withdrawn from US market in 2002

Birth Control Implants

Norplant

A thin rod inserted under the skin of the upper arm, containing a synthetic hormone that is released into the body over three years.Same mechanism of action as Pill. Pain at insertion site, acne, increased BP, increased clots, irregular bleedingSame mechanism of action as the Pill, Patch, Ring, DepoBroken or Migrating RodsWeight Gain, Nausea, Depression, Infection, Ovarian Cysts, headache, migraines, breast tendernessIncreased Risks for Breast Cancer, Liver Disease, Blood ClotsNorplant Withdrawn from US in 2002Over 50,000 women filed lawsuits against Wyeth in first 6 years

Emergency Contraception

Known as the morning-after pill, EC is a high dosage of the birth control pill.Plan B is used to prevent pregnancy after an unprotected sexual encounter. It works by delaying ovulation and fertilization, and perhaps preventing implantation in the uterus. It does not terminate an established pregnancy. (According to the ACOG definition of pregnancy)Progestin-only EC Nausea and vomiting Breast tenderness Ectopic pregnancy Blood clot formationThe first tablet of Plan B should be taken as soon as possible, within 72 hours (3 days) of unprotected sex. The second should be taken 12 hours later.

The most common side effects of Plan B include nausea, abdominal pain, fatigue, headache and menstrual bleedingRU-486 Mifepristone + Misoprotol Referred to as the abortion pill but is actually a process of consuming multiple pills Man-made steroid designed to work against a womans normal, natural state during pregnancy. First visit RU486 pills given to kill baby Second visit Misoprostol pills/suppositories given in attempt to expel the dead baby Final visit If RU486 failed, surgical abortion scheduled Side effects: nausea, abdominal pain, vomiting, heavy and extended bleeding, heart attack, hemorrhage, impaired future fertilityAlso called the abortion pill

During pregnancy, the preborn baby requires a hormone called progesterone. This chemical is produced natually in the mothers body. It is so valuable to the babys proper growth and development that some call progesterone natures pregnancy hormone.

RU-486 works against progesterone by breaking down and then destroying the surroundings that the baby has established in the mothers womb. It eventually destroys the baby as well by cutting off nourishment to the preborn child, who starves to death inside his mothers womb.

FDAs Approval of RU-486FDAs Approval of RU-486 (developed by the Population Council)The median total review time for new drug applications is 14.8 monthsFDA review time for RU-486 was 6 months.FDA quickly approved RU-486 on fast track process reserved for drugs used for life threatening diseases

RU-486 Expedited Clinical Trials3-8% UnsuccessfulPain, Nausea, Cramps, Bleeding, Vomiting3% Required Blood Transfusions or SurgerySeveral Maternal Deaths linked to RU-486

A similar abortion drug was secretly tested in Philippines & Mexico as tetanus vaccineIntra-Uterine Devices

A small, flexible, plastic t-shaped device that contains either copper or the hormone progesterone and is inserted into the uterus by a clinician to prevent pregnancy. The UID can be left in place for 1 to 10 years, depending on the type of IUD.The IUD is an object that is placed inside the uterus by a physician. Intra-Uterine DevicesHow It Works:

Kills sperm before they reach the ovum, affecting cervical mucus Inhibits implantation IUD containing progesterone also can inhibit ovulation to some degree

Although doctors claim they arent quite sure how the IUD works, it is clear that the IUD does not prevent ovulation, which means that the womans body will still produce an egg during her monthly cycle.

When the IUD is put in place, it and the chemical it contains alters the fluids in the womb, and the lining of the womb. The presence of the IUD irritates the lining, preventing implantation.Intra-Uterine Devices Increased risk of miscarriage (spontaneous abortion) Ectopic (extrauterine) pregnancies 10 times above usual incidence Pelvic inflammation that can cause sterility Anemia due to excessive menstrual bleeding Embedding, migration of fragmentation of IUD Spotting or prolongation of menstrual flow Increased risk of infection Occasional perforation of uterus, cervix, or bladder requiring surgery Backache Copper toxicity poisoning of the organs Localized pain that persists each time ovulation occursOverviewHow the Body Naturally WorksHistory of Hormonal ContraceptivesHow Contraception Unnaturally worksWhat does Planned Parenthood say about Hormonal ContraceptivesHealthy Alternatives to Contraceptives

36What does Planned Parenthood have to say about Oral Contraceptives?

Quotes from Margaret Sanger, Eugenics Promoter & founder of Planned Parenthood:

More children from the fit, less from the unfit that is the chief aim of birth control Birth Control Review, May 1919The most merciful thing that a large family does to one of its infant members is to kill itWomen and the New Race, 1920(The purpose in promoting birth control) to create a race of thoroughbredsBirth Control Review, November 1921Couples should be required to submit applications to have a childBirth Control Review, April 1932

What does Planned Parenthood have to say about Oral Contraceptives?(pregnancy is) an episodic, moderately extended chronic condition may be defined as an illnesstreated by evacuation of the uterine contentsDr. Warren Hern, Is Pregnancy Really Normal? Family Planning Perspective, Planned Parenthood vol 3, no 1, Jan 1971, pg1.

If your parents are stupid enough to deny you access to birth control, and you are under 18, you can get it on your own. Call Planned ParenthoodAd in Dallas Observer, Jan 30, 1986No. You do not need your parents permission to get birth control at Planned Parenthood, and we will not tell your parents that we have seen you. At Planned Parenthood all of our services are confidential (for) teens age 12 and older.Article on Planned Parenthood websiteWhat does Planned Parenthood have to say about Oral Contraceptives?Today, we have many safe and effective birth control methods available to usPlannedParenthood.org

Do Combined Oral Contraceptives delay a womans return to fertility?NO: International Planned Parenthood websiteYES: 1 to 2 month delay: PlannedParenthood.org

What does Planned Parenthood have to say about Oral Contraceptives?Do IUDs, Implants or Injectibles cause Abortions?

International Planned Parenthood NOPlannedParenthood.org There is no Proof this actually happens:

American College of Obstetricians & Gynecologists (ACOG.org) Hormonal IUD thins the lining of the uterus. This keeps a fertilized egg from attaching.Copper IUD can prevent the egg from attaching to the wall of the uterus.

What does Planned Parenthood have to say about Oral Contraceptives?A main reason people use contraception?A smaller # of children better quality of life: International Planned ParenthoodMore kids Happier marriage: San Francisco University studyVery Happy3.25Pretty Happy2.98Not Too Happy2.46% Very Happy7+ kids (74%)1-6 kids (58%)

OverviewHow the Body Naturally WorksHistory of Hormonal ContraceptivesHow Contraception Unnaturally worksWhat does Planned Parenthood say about Hormonal ContraceptivesHealthy Alternatives to Contraceptives

42Healthy Alternatives to Hormonal ContraceptivesEffectiveness RatesNothing 15%Spermicide 74%Withdrawal 81%Condom 84~85%Oral Contraceptive (pill) 92~95%IUD 98~99%Sterilization 99+%NFP 99+%Abstaining 100%

Comparison of Artificial Methods of Birth Control and The Ovulation Method U.S. Statistics 1992

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BleedingDry DaysDry DaysOvulationPre-ovulatoryrelativelyInfertile phasePost-ovulatoryInfertile phaseFertile phase

Natural Family Planning45Why Use NFP?Safe100% naturalHas no health risksDoes not involve potentially harmful birth control drugs or devices

HealthyIt teaches a woman to become aware of her normal fertility pattern.Changes in a womans fertility pattern can alert her to possible medical problems.46Advantages of Using NFPCan be used to achieve or avoid pregnancyEffective in all reproductive circumstances:Regular or irregular cyclesBreast feedingPre-menopauseEtc...Early detection and diagnosis of fertility disordersImmediately reversibleNo alteration of physiologyNo side effectsNot technology dependant, no harmful devices47Advantages of Using NFPEasy to LearnEasy to UseMinimal CostInvolves the CoupleMorally AcceptableMore satisfying marriagesDivorce rates: 50% vs. 2%48U.S. Studies on Method Effectiveness of the Ovulation MethodStudyYearCouplesCyclesPreg. rateSt. Cloud197426018230.6%Dolack197832933541.1%Klaus, H et al.1979109012,2821.17%Klaus, H1981728080%Wilson, M(Guatemala)1997-199993710,8720.65%49Resources American Life League www.all.org Billings Ovulation Method Assn www.Boma-usa.org Breast Cancer Prevention Institute www.bcpinstitute.org Couple to Couple League www.ccli.org International Planned Parenthood www.ippf.org Family of the Americas Foundation www.familyplanning.net National Institute of Health www.nih.gov One More Soul NFP Center www.OMSoul.com Pope Paul VI Institute www.popepaulvi.com Planned Parenthood www.plannedparenthood.org University of San Francisco www.userwww.sfsu.edu World Health Organization www.who.int

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