Contraceptives and the Environment - What the Pill Is Doing to Our Water Supply

By Rebecca Oas, PhD

WASHINGTON, D.C., MAY 16, 2012 (Zenit.org).- In 1960, the combined oral contraceptive pill was first approved for use in the United States. Seven years later, “the Pill” was featured on the cover of Time Magazine, illustrating its enormous societal impact[1]. Roughly two generations later, statistics from the United Nations show that, within more developed nations worldwide, just under 16% of “partnered” women use contraceptive pills, a number which does not include usage among single women[2].

However, even as the popularity of oral contraceptives remains high, the drugs themselves have been evolving in response to further discoveries about the human reproductive system, as well as efforts to reduce the Pill’s negative side effects. As with any major technological or medical development, particularly one embraced very quickly by a large sector of the population, it can take years, and even decades, for the full range of effects to become evident. And as demonstrated by several recent studies, many questions remain unanswered regarding the long-term and environmental effects of the hormones used in oral contraceptives, as well as other medical treatments.

When a new synthetic substance is created, or a naturally occurring substance is generated at greatly increased levels, the effects can be far longer-lasting and wider-reaching than its manufacturers predict or intend. Some well-known examples of this include asbestos, a popular insulation and flame retardant in the late 19th century, which was later discovered to be carcinogenic; and polystyrene foams like Styrofoam, which is frequently used in disposable packaging, yet takes hundreds of years to break down once discarded. In the case of oral contraceptives, the key ingredients are synthetic hormones known as progestins, which mimic progesterone, either alone or combined with estrogen. When used therapeutically in contraceptive pills or in hormone replacement treatments for menopause, these synthetic hormones make their way into the water supply after being excreted in the patients’ urine. As environmental contaminants, these are referred to as endocrine-disrupting chemicals (EDCs), due to the fact that they interfere with the endocrine systems of humans and animals alike following exposure.

While its impact is still being widely studied, there is no doubt that the exposure is occurring: multiple international studies have documented elevated levels of natural and synthetic hormones in drinking water, and one such study conducted in France noted that progestins in particular were more resistant to removal by water treatment methods, compared with other types of pharmaceuticals (3).

Due to the accumulation of synthetic steroids in water, much of the research conducted on its impact has been done using water-dwelling vertebrates such as fish and frogs. An ever-increasing collection of studies report harmful effects of these hormones on aquatic vertebrates, particularly with regard to their reproduction, as would be predicted given the nature of the contaminants (4). One study focused on the effects of exposure to the progestin Levonorgestrel (LNG) on the frog Xenopus tropicalis. While the male reproductive system did not appear to be impaired, female tadpoles exhibited severe defects in the development of their ovaries and oviducts, rendering them sterile (5).

While studies such as these cannot be taken as a direct assessment of the impact of environmental EDCs on humans, they do have certain advantages: the capability of controlling for the duration and concentration of exposure, and the fact that these animals’ life cycles are much shorter than those of humans, thus enabling multigenerational studies in far less time. Like the proverbial “canary in the coal mine,” animal studies can serve as early indicators of environmental conditions that may prove harmful to humans and direct our attention toward seemingly innocuous substances we encounter in the air we breathe, the food we eat, and, as in this case, our water supply. However, the effects of EDCs are not limited to water-dwelling frogs: female sterility resulting from early exposure to progestins has been reported in studies involving rats and mice, whose mammalian reproductive systems more closely resemble those of humans (6). The female reproductive system undergoes many key developmental changes in the early stages of life, and these changes are dependent on endocrine signaling events that are sensitive to contaminating environmental hormone exposure. A series of studies by a group at the National Institutes of Health (NIH) have demonstrated that mice exposed to phytoestrogens – plant estrogens such as those found in soy products – at key developmental time points exhibited impaired fertility (7). In contrast to mice, in which the critical period of time is during the neonatal period, the human female reproductive tract is undergoing development from prior to birth through adolescence. Therefore, it is necessary to evaluate the risk of exposure to EDCs across a broader window of time, beginning in the womb.

The use of hormonal contraceptives by pregnant women is discouraged for the obvious reason that they are not ovulating, in addition to the potential for harm to the unborn child. However, postpartum contraception guidelines issued by the Centers for Disease Control in 2011 state that the use of progestin-only contraceptives “can be initiated immediately postpartum,” and discourage the use of estrogen-containing combined contraceptives in breastfeeding women primarily because the estrogen can reduce the mother’s milk supply (8). The presence of progestins in the breast milk of women taking oral contraceptives has not been demonstrated to adversely affect their babies’ health, although such assessments tend to focus on the short-term outcomes rather than those that might not manifest until adulthood. Nevertheless, the most recent report from the NIH group studying the effects of phytoestrogens highlights the notion that limiting early exposure to plant estrogens, such as those found in soy-based infant formulas, may prove to be beneficial to female reproductive health in the long term. Furthermore, the potential harms of prevalent EDC pollution in the environment are not restricted to women: in November of last year, the British Medical Journal published a report indicating that levels of prostate cancer in men are highest in geographic areas with the greatest use of oral contraceptives (9). While the authors stress that their findings are correlative rather than causative, their work provides a sobering hypothesis for further important research.

Ultimately, the Catholic opposition to contraception is grounded in a fundamental understanding of the meaning of human life and the purpose of procreation as a part of God’s plan, not a pragmatic conclusion reached by painstaking scientific research. While it makes intuitive sense that humans both individually and as societies benefit by living in accordance with the wishes of their Creator, in a fallen world there are practical things that can be done to alleviate some of our suffering, including the use of medical technology and pharmacology. It should be noted that synthetic hormones are not exclusively used in contraceptives, nor are the chemical compounds marketed as contraceptives intrinsically immoral – for instance, an unmarried and abstinent woman using hormonal treatments to treat endometriosis in the hopes of safeguarding her future fertility is doing nothing sinful, regardless of the efficacy or side effects of her decision. However, in a world in which influential groups and individuals are increasingly advocating for population control, often in a manner that recalls the eugenics movement of decades past, it is necessary to insist that research be done to uncover truths regarding the long-term and unintended side effects of widespread contraceptive pill usage.

* * *

Rebecca Oas, Ph.D., is a Fellow of HLI America, an educational initiative of Human Life International. Dr. Oas is a postdoctoral fellow in genetics and molecular biology at Emory University. She writes for HLI America's Truth and Charity Forum.

--- --- ---

1) Time Magazine, April 7, 1967. http://www.time.com/time/covers/0,16641,1101670407,00.html

2) United Nations: World Contraceptive Use (2005) http://www.un.org/esa/population/publications/contraceptive2005/2005_World_Contraceptive_files/WallChart_WCU2005.pdf

3) Vulliet E; Cren-Olive C, Grenier-Loustalot MF. Occurrence of pharmaceuticals and hormones in drinking water treated from surface waters. Environmental Chemistry Letters (2011) 9:103–114

4) Whitacre DM. Reviews of Environmental Contamination and Toxicology, Volume 218. Spring, 2012

5) Kvarnryda M, Grabic R, Brandt I, Berg C. Early life progestin exposure causes arrested oocyte development, oviductal agenesis and sterility in adult Xenopus tropicalis frogs. Aquatic Toxicology 103 (2011) 18–24

6) Uzumcu M, Zachow R. Developmental Exposure to Environmental Endocrine Disruptors: Consequences within the Ovary and on Female Reproductive Function. Reproductive Toxicology. 2007; 23(3): 337–352.

7) Jefferson WN, Patisaul HB, Williams CJ. Reproductive consequences of developmental phytoestrogen exposure. Reproduction (2012) 143 247–260

8) Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: Revised Recommendations for the Use of Contraceptive Methods During the Postpartum Period. CDC, July 8, 2011.

9) Margel D, Fleshner NE. Oral contraceptive use is associated with prostate cancer: an ecological study. British Medical Journal Open. 2011 Nov 14;1(2)

And despite the data that they can break down in nature, or could be filtered out, frankly, they don't necessarily do so, and they aren't necessarily being filtered out, and we've known this for a long time now:

Flushed hormones change sex of fish [what are they doin' to you???]
The Ottawa Citizen ^ | Saturday, January 05, 2002 | Tom Spears

Posted on Sunday, January 06, 2002 12:50:00 AM by Dr. Brian Kopp

Flushed hormones change sex of fish
Synthetic estrogen in water from sewage causes male fish to produce eggs: study

Tom Spears
The Ottawa Citizen

Saturday, January 05, 2002

Women who take birth control pills or hormone therapy are flushing enough hormones down the toilet to make male fish downstream produce eggs, a Canadian study shows.

Synthetic estrogen in the women's urine goes through sewage treatment plants without being completely broken down, and the fish absorb it, with bad effects following.

Male fish produce eggs in their testes. Female fish are stimulated by the extra hormones to produce eggs at the wrong times of year.

And there are questions, still unanswered, about whether these chemically altered fish are capable of reproducing at all.

Scientists have seen this "gender-bending" effect in fish downstream from sewage plants, but lacked proof that birth control pills are a cause.

So Karen Kidd of Fisheries and Oceans Canada started dribbling bits of the synthetic hormone from birth control pills into a 34-hectare lake in northwestern Ontario, west of Dryden, to find out. The lakes are so remote they don't even have names (this one is called Lake 260) and are perfectly suited to act as giant experiments because they are practically untouched by pollution.

Sure enough, the male lake trout, white suckers, fathead minnows and pearl dace turned up this fall with proteins that females use to manufacture egg cells, and in some cases with the eggs themselves.

"The question now is whether this feminization is affecting the population size or sustainability," she said. "Can males with eggs in their testes reproduce effectively? Can they contribute to the population?"

It will take another summer of adding chemicals, and a couple of years of counting fish afterwards, to know the full effects. But Ms. Kidd is finding an interested audience in Vancouver this weekend, where she will show her early results to a conference of fisheries scientists.

"People consume the birth control pills and it's lost from their bodies and goes into the sewage," said Peter Leavitt, a biology professor at the University of Regina. "So we get this huge population in sources like cities, dumping this very high concentration of hormones into the water bodies. And the question is: Is it having an influence?

"It seems to be mimicking some of the reproductive hormones that other organisms use, and it's basically messing up their reproductive strategies," he said. "I think it's really significant," because no one thought of human sewage as a source of this type of pollution before, he said.

"And what Karen is showing is that there are consequence of large numbers of people living in an area ... It's not so much that we're destroying their (the wildlife's) habitat. But we're actually changing the chemical environment in which they live and breathe."

Ms. Kidd says both natural and synthetic estrogen go into sewage in urine, but bacteria take longer to break down the synthetic version, which means more of it gets into the fish.

For 10 years scientists have studied chemicals that act like estrogen in fish, other wildlife, and even humans that eat tainted fish. Many of these come from pesticides or industrial waste and are never intended to be like hormones at all. But this study is unique in looking at real hormones flushed down the drain.

Ms. Kidd says both natural and synthetic estrogen go into the sewage system in urine, but bacteria take longer to break down the synthetic version, which means more of it gets into the fish.

The Lake 260 experiment uses the amount of hormone that would come from 6,000 women taking the pill, she said.

Thanks, I also wrote about this back in 2010:

Media Manipulation and The Pill
Brian J. Kopp
Saint Gianna Physician Guild

Two months have passed since the publication of comments by Carl Djerassi, one of the co-creators of the synthetic progestagen Norethisterone, warning of demographic catastrophe in Austria. Given his credentials, his comments in the Austrian newspaper Der Standard could hardly be ignored by the worldwide press and medical establishment. Following a firestorm of controversy, Djerassi has demanded corrections in the media. Writing in The Guardian, Tuesday 27 January 2009, he claims that "I never blamed the pill for the fall in family size."
In the same week, the president of the World Federation of Catholic Medical Associations, Dr. Jose Maria Simon Castellvi, writing in L'Osservatore Romano, highlighted the abortifacient effect of the Pill as well as its environmental impact. The fact that the Pill is contaminating drinking water supplies has been known since the early 1990's, with alarming transgender effects on fish downstream from water treatment facilities. According to CNA, Dr. Jose Maria Simon Castellvi noted the “devastating ecological effects of the tons of hormones discarded into the environment each year. We have sufficient data to state that one of the causes of masculine infertility in the West is the environmental contamination caused by the products of the ‘pill’.”

The mainstream media and medical establishments responded in predictable fashion.
For instance, according to the Austrian Times,
Angelo Bonelli, of the Italian Green party, said it was the first he had heard of a link between the pill and environmental pollution. The worst of poisons were to be found in the water supply. "It strikes me as idiosyncratic to be worried about this."

A leading gynaecologist and member of the New York Academy of Science, professor Gian Benedetto Melis, called Simón's claims "science fiction", saying that the pill blocked ovulation only.

On December 13, 2008, the same week as Djerassi's controversial comments, the American Journal of Epidemiology published a study titled "A Case-Control Study of Oral Contraceptive Use and Incident Breast Cancer." This study, which once again demonstrated an increased risk of breast cancer from the use of oral contraceptives, has received no press coverage whatsoever.

The reluctance of the media to cover negative news on the Pill is not new. Chris Kahlenborn, MD, is the author of a key article published in October 2006 in the prestigious journal Mayo Clinic Proceedings entitled “Oral Contraceptive Use as a Risk Factor for Pre-menopausal Breast Cancer: A Meta-analysis.” His meta-analysis of the world literature found that oral contraceptives were linked with a measurable and statistically significant association with pre-menopausal breast cancer. I asked him about Djerassi's comments and the media embargo of the December 2008 American Journal of Epidemiology study.

Q: Does this study confirm the findings of your meta-analysis?
A: Yes, Rosenberg noted a 60% increased risk of developing breast cancer in women age 50 or under who took oral contraceptives. We found a 52% increased risk in the same group of women if they took the pill for four years or more prior to the birth of their first child.
Q: Why would these researchers fail to cite your meta-analysis?
A: Dr. Rosenberg has noted in the past that she does not put much credibility in meta-analyses as a whole, however, given that our’s is the only current meta-analysis out there, it seems she surely knew about it and chose to avoid mentioning it. I am not sure why.
Q: At present, how many studies have confirmed this risk and how many have found no risk?
A: 22 out of 24 studies have found an increased of premenopausal breast cancer in women who took oral contraceptives prior to the birth of their first child.
Q: In layman's terms, what are the cancer risks for women taking oral contraceptives (including other types of cancers)?
A: Women who take oral contraceptives increase their risk of breast, cervical and liver cancer and decrease their risk of ovarian and uterine cancer.
Q: Do the recent comments of Austrian Carl Djerassi change the nature of the debate?
A: Perhaps slightly but not much. The media as a whole has refused to cover the oral contraceptive-breast cancer link, mostly for ideological reasons in my view. I recently had contact with some of the editors of USA Today and asked them if they would do a story on Rosenberg’s paper as well as ours. They said they already addressed it. I challenged them to tell me of one time they or any other major media had addressed either paper. I almost guarantee you that they will cease corresponding with me from this point onward.

Unfortunately, this type of “hide for cover” by “not covering” a story is typical. In 2006, after our meta-analysis came out in the Mayo Clinic Proceedings the New York Times called the Mayo Clinic to get a copy of it. I feel certain they read it, but they have never done a story on it. Bottom line: if it does not fit the mainstream media’s ideological purpose, they simply pretend the medical studies were never published and refuse to cover them.
Dr. Kahlenborn's research can be reviewed online at The Polycarp Research Institute.

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.