Athena Nalina

INFORMED CONSENT HAS NEVER BEEN A PART OF THE HORMONAL BIRTH CONTROL PRESCRIPTION I don't make any judgements regarding a woman's right to control her own reproduction. That decision belongs to her, and nothing below will argue otherwise. My target is the Physicians and their prescription pad, and the conversation that never happens before the doctor writes the script. Hormonal birth control has done more damage to women's mental, emotional, and physical health than any other factors or combination thereof I've seen in decades of consulting. That's an ironclad conclusion that I can defend with little to no effort though I am happy to do so if pressed. Picture the standard scene. A young girl gets her first period and within months, her doctor offers her the pill with promises of clearer skin and to address her "heavy periods." No one has a clue whether her periods are heavy, because she's had maybe three of them. The doctor is offering a treatment for a problem that hasn't presented itself yet, with a drug that overrides an endocrine system that has barely begun to calibrate. Doctors rarely tell their patients that the pill shuts down a woman's own production of estrogen and progesterone and replaces it with synthetic hormones. The estrogen in most pills is ethinyl estradiol, a different molecule from the estradiol her body makes, and her own estradiol falls while she takes it. Estrogen does most of the work for mood because it acts on serotonin and dopamine in the brain, and testosterone adds to it. Oral estrogen also raises SHBG (sex hormone binding globulin, the protein that attaches to testosterone, estrogen, and DHT and pulls them out of circulation), so her free testosterone drops and Testosterone contributes a large share towards driving female libido and motivation. The pill exists to stop conception, and a side effect never mentioned is a young woman who ends up with the sex drive of a eunuch. A drug that exists to prevent pregnancy ends up removing most of her interest in sex. That's not the mechanism of action promised to these young women. Then the flat mood and the anxiety arrive. She goes back to the same medical system, and the doctor prescribes an SSRI or an anxiety medication. SSRIs carry their own sexual side effects, so two prescriptions have now pushed her drive down, and no thought goes into whether the first one had anything to do with the second. Her doctor just promised her clearer skin and a predictable flow. If you're a physician who writes birth control prescriptions, here's what you are obligated to tell every woman before you write one: 1️⃣ It shuts down her own estrogen and progesterone production for as long as she takes it. 2️⃣ It raises SHBG, which binds testosterone and lowers her free testosterone. 3️⃣ It lowers libido in a meaningful share of the women who take it. 4️⃣ It's associated with depression and anxiety, and with higher antidepressant prescribing, especially in teenage girls. 5️⃣ It raises the risk of blood clots, and the risk of stroke and heart attack climbs in women with added risk factors like smoking or migraine with aura. 6️⃣ It can raise blood pressure. 7️⃣ It changes her lipids, including leading to higher triglycerides. 8️⃣ It raises thyroid binding proteins, which changes how her thyroid labs read. 9️⃣ It slightly raises the risk of breast and cervical cancer, while lowering the risk of ovarian and endometrial cancer. 🔟 The monthly bleed on the pill is a withdrawal bleed, not a true period, so it hides whether she has a cycle problem underneath. 1️⃣1️⃣ The Depo shot (straight poison BTW) carries a boxed warning for loss of bone density. 1️⃣2️⃣ Headaches, nausea, breast tenderness, and breakthrough bleeding are common. If you haven't told every woman you've prescribed hormonal birth control to every item on that list, you are a problem, and that's irrefutable. Every prescription you wrote without that conversation is a clear breach of your duty to obtain informed consent.