I got to review Malcolm Gladwell’s latest book, and as highbrow easy reading goes, he’s pretty hard to beat. One of his essays, on the creator of the Pill, provides much food for thought from a pro-woman perspective.
He identifies Dr. Rook’s major error in being maintaining a 28 day cycle for contraceptive pills, which he did in the belief that, by mimicking nature, this method would gain approval amongst Catholics (being one himself). What’s especially fascinating, though, is his look at the research into menstruation in pre-industrial societies.
What he demonstrates is that, in a state of nature, women would have perhaps 100 menstrual cycles in their lifetime, while for women in the developed world today, it can be as high as 500 cycles. Since each cycle involved changes to breast, endometrial and ovarian tissue, and since malignant growths are often found when cells must repeatedly regenerate (why sunburns are linked to skin cancer, and smoking to lung cancer), reducing the number of menstrual cycles a woman experiences should in theory reduce their risk of reproductive cancers. And what evidence there is in this area bears the theory out. The factors in nature that reduce the number of cycles aren’t ones we would like to recreate: late onset of puberty caused by malnutrition, for instance, or a high infant mortality rate. At least one of them, we can influence: breastfeeding reduces these risks, in part because it suppresses ovulation for a time after birth. This is why reproductive cancers have long been known to be less common among women who carry multiple children to term and breastfeed them: each birth would represent anywhere from 12 to 24 months without ovulation.
Now my two major concerns with the Pill are that it sometimes (we don’t know how much) acts as an abortifacient, and that its effects on women’s health are mixed – while it reduces risk of ovarian cancer, the benefits it confers with respect to breast cancer are cancelled by the risks it carries due to, it seems, synthetic hormones. The current Holy Grail of researchers, according to Gladwell, would be a birth control pill that suppresses ovulation all the time, thus reducing the repeated changes that can lead to cancer, as well as preventing the fertilization of an egg, since no egg would be released; and to do this with hormones that would have no adverse effects on risk of breast cancer, or anything else.
So, since I have no philosophical objection to birth control, I find myself thinking that such a Pill would be a very good thing. This is despite my general aversion to medical intervention without a good reason. The impression I got from Gladwell’s essay is that this may be just around the corner.
Andrea adds: Rebecca’s full review is here.by