Have you read Part 1 of my No-Panic Guide to the Birth Control Pill? If not, please do so before scrolling down.
I’ll continue in the same line of thought with the second (and last) part: my goal is to make you UNDERSTAND the risks associated with the Pill so that you can look at what you read and hear from a different angle.
I won’t tell you what to do: what I hope is to offer you a place to start and give you the necessary tools to promote enlightened reflection.
While deciding on what to incorporate, I took into account the myriad comments and suggestions I received after the publication of Part 1. Obviously, I couldn’t cover everything. I would’ve gladly added a section dedicated to cancer and depression, discussed the alternatives to hormonal contraception, provided more practical examples… but I decided to limit the scope of the last comic in order to keep everything “digestible”.
I don’t expect everyone to be engrossed by the topic, let alone read it in its entirety. Without doubt, it’s the longest comic I’ve produced so far and it’s quite stuffy… I tried to shorten it as much as possible, but under no circumstances would I cut corners on such a serious and complex topic. My goal was to give women the necessary information for them to do their own critical thinking (such as being wary of allegations made by the media) and encourage open discussion with their doctors in all matters concerning the contraceptive pill.
If you manage to read the entire thing, you automatically win a bag of 1000 gummy bears that you can claim if you ever meet me in person.
In order to make sure that my comic is accurate, I asked for the help of Lyne Massicotte, a clinical biochemist. Lyne, whose work I greatly admire, is the cofounder – with her partner Mathieu – of Nasci Biologie Médicale, a medical lab specializing in male fertility. Thanks Lyne!
Translated by Qian Li (Pharm.D. candidate), proofread by Stéphanie Alcaraz-Robinson.
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References:
– The introduction of the 2015 Canadian Contraception Consensus provided inspiration for this comic. Here’s an excerpt that stood out for me: « (…) the media often sensationalize the potential risks of modern contraceptive methods. In doing so, the media may inform, partially inform, or misinform women about methods of contraception in a way that can lead to discontinuation of a contraceptive method without a switch to another reliable form of contraception. Health care providers must be aware of current and ongoing media contraception controversies in order to obtain evidencebased facts and correct information that can be briefly and directly communicated to women, thereby allowing them to make informed decisions about their reproductive health. »
http://www.jogc.com/article/S1701-2163(16)30043-3/fulltext
– I took a lot of info from Dr. Marc Zaffran’s website on hormonal contraception, which unfortunaterly is only available in French: http://martinwinckler.com/spip.php?rubrique8
– Practical examples were inspired by the guidelines developed by the Professional Order of Pharmacists in Quebec (OPQ), called « Contraception hormonale : Conseiller et guider dans la bonne direction » (May 2008).
– Non-contraceptive nenefits of hormonal contraceptives: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693657/
– Oral Contraceptives and Cancer Risk, according to the National Institutes of Health (NIH): https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet
– The numbers for the risks of DVT are from The American Congress of Obstetricians and Gynecologists (ACOG) : http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Risk-of-Venous-Thromboembolism
– Similar numbers can be found in this systematic review: https://www.ncbi.nlm.nih.gov/pubmed/23530659
– As mentioned in the intro, I didn’t really cover the issue of depression in this comic. In this systematic review (http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2552796), the risk of depression was 0.2% without taking the Pill vs 0.4% while taking the Pill. So the risk remains very low overall.
That was very informative and super helpful, thank you!
PS. I read both part one and two and I didn’t think part two was too long at all!
Thanks so much Ashleigh!
Olivier