Category: Science and Technology

Quick Hormonal Birth Control Science Explainer

Yesterday, I saw a guy suggest that women who lose insurance coverage can go buy one of seven birth control brands offered by Walmart for $9—and that sounds like a broadly-applicable solution, but only if you don’t understand hormonal birth control. Most birth control pills have two hormones in them: one which convinces your body it’s producing a hormone it isn’t producing, and one which binds with a hormone in your bloodstream to mask it and convince your body it isn’t there. There are more than a dozen variations of each of these components, and hundreds of ways they could be combined.

How a given hormonal combination reacts with the body of an individual woman varies widely. The same pill will raise one woman’s sex drive and kill another’s. It’ll clear up one person’s acne and give another one acne. It’ll cause one to gain weight and one to lose it. It might be mood stabilizing, or cause severe depression. There are hormonal sliders the pill is moving, and you have no way to know in advance what this woman’s presets are, let alone how responsive her sliders will be to a set of chemicals she hasn’t tested personally.

Think of birth control pills as if they’re chili. There’s a whole bunch of different things called chili, and even if you know you want chili, a particular batch might have no ingredients in common with another batch. It might include elements you’re allergic to, or might be too spicy, or it might have none of the characteristics you want when you say “chili”. Beans v no beans, white v red, chicken v beef v vegetarian – the world of chili is vast.

Unlike with chili, you need a prescription for hormonal birth control, because although you’re probably safe if you’re on the same pill you’ve been taking for a while, you don’t really know how your body is going to react to a new one and it could react by forming blood clots that try to kill you. Testing a bunch of different kinds is strongly discouraged, and also impossible because your pharmicist wouldn’t give you a different kind of pill than the one prescribed to you. On top of that, the first month after you switch or start a pill variant is the most dangerous – is the time you’re most likely to have a life-threatening adverse reaction. When you think about switching types, you weigh that risk against the side effects you’re already experiencing.

(Why not opt out if it’s so dangerous, you might say. The answer is that pregnancy is even more dangerous. Sincerely, that is the reason the FDA thinks the risks are acceptable for female hormonal birth control but not male hormonal birth control.)

To make this less abstract, here are three forms of hormonal birth control I have used and how my specific body reacted to them:

Microgestin (norethisterone acetate and ethanyl estradiol) is great for me. I feel totally normal for the most part, with better skin and a slightly increased sex drive which is enough to be fun but not inconvenient.

Microgynon (levonorgestrel and ethanyl estradiol) is what I was prescribed when I moved to England, where Microgestin was not available. It makes me way more teary than my normal self. Not for the most part depressed, but more likely to burst into tears over something small. During two of the seven days of the month when I took spacer pills (the ones with no hormone that allow you to experience withdrawal bleeding, aka fake period) I felt delicate and bereft and wanted to be held by my partner – felt like I was mourning a very early miscarriage. This is a strange experience to get from a pill you take to ensure an egg will never be released and fertilized, and it felt simultaneously real and fake, the way “hangry” feels falser than angry.

Qlaira (dienogest and estradiol valerate) is what I was prescribed in Italy. The first month, I had terrible headaches. Those cleared up, but for the entire two years I was on this, I was emotionally flat and had no sex drive, and experienced constant dryness in parts of my body that shouldn’t have been dry. I didn’t get my libido back until more than a month after I stopped taking it.

None of this is a guide to what other women could expect. We can’t compare notes and say “I liked this one; you should try it” or “you have almond-shaped eyes, so clearly the best pill for you is lavender-colored.” However, you can see why maybe it could be a significant daily burden not to be able to take your preferred pill formulation. Of the three pills I listed above, Migrogynon is the only one with generic $9 Walmart equivalents. Otherwise, they offer progesterones I haven’t tried: norgestimate, norethisterone (not the same chemical as norethisterone acetate), and desogestrel.


New BBC shortform doc about the Great Green Wall

Watch it here.

The most sci-fi moonshot project going on right now isn’t the hyperloop—it’s the Great Green Wall. They are literally fighting a battle to hold back the desert with a gigantic created forest that cuts all the way across Africa. It’s like the Wall in Game of Thrones, but with heat and not cold. The African Union has been building it since 2005 (I don’t know how to get across how huge it is) and I love it and will always post news stories about it. Hats off to Senegal particularly.

Drawdown, by Paul Hawken

Interesting new book for solarpunk peeps and environmentalists which talks about carbon drawdown strategies (because 100% renewable energy, even if it could be achieved, would not pull out the stuff that’s already in the air)—Drawdown, by Paul Hawken. Haven’t read it yet, but here’s some of what came up in the interview.

Top of the list for reducing emissions isn’t cars or planes or making things last—it’s disposing of refrigerators and air conditioners when they get too old. 90% of CFC and HCFC leakage happens when the coolant system is starting to conk out and die. No big loss to get rid of that machine, which was already breaking down. If we can convince people to do that instead of trying to stretch it out (maybe because of cost, maybe because of a laudable but in this case misplaced desire to conserve), and can dispose of it safely, that keeps 90-100 gigatons of CO2 equivalents out of the air between now and 2050.

A carbon capture strategy I hadn’t heard of before is Silvopasture, which is farming trees and grazing animals simultaneously. In other words, your pasture has trees on it (sylvan). This makes you more money if you want to sell the trees. It keeps your animals healthier (cows for instance like the shade) and your land healthier. And it sequesters carbon. If you’re writing optimistic SF, maybe include domesticated animal herds in managed forests. (There are other direct carbon capture mechanisms being explored, but the the only method that is currently reliable is photosynthesis.)

Finally, peace has a carbon dividend. Wars are terrible for the environment, and not just in a “they’re bombing the land to pieces” way. Sometimes cynical people think “well, at least this is decreasing population” and think they’re being analytical and brave to say something so horrible. But they’re wrong. Wars use a lot of energy. Wars destroy ecosystems. Wars grind through every resource you can think of, even to move the soldiers and fleeing people around. Peace is much better for preventing global warming.

Bob Massie for Massachusetts Governor

The next Massachusetts gubernatorial election isn’t until November 2018, but candidates on the Democratic side have started fundraising and forming exploratory committees. (On the Republican side, it’s assumed incumbent governor Charlie Baker will be the candidate.) One of the early declarers is Bob Massie.

There is probably nobody in the U.S. with more experience combatting climate change through legislative and business initiatives. (Executive director of Ceres for almost two decades.)

Also, he has had hemophilia from birth, so you know he cares about protecting people with pre-existing conditions. (Also, he was on the ethics advisory committee of Boston Children’s Hospital. Also, he’s an Episcopal minister, and this is core Episcopalian stuff.)

Also, he’s a Fullbright scholar who wrote the go-to history of U.S.-South Africa relations during Apartheid.

This guy, I’m telling you—check him out. His face is boring, but his biography is not. If anything, Governor of Massachusetts seems like too small a job for him.

Here’s his twitter.

Sonya says: I’ve heard him speak. Not a lot of flair, but solid intellectual content, which right now I am much more for than style. Also, that biography is ridiculous.

Romie: Yeah. If he was in some SF I was editing, I’d tell the author to split him into three characters. And even then, tone some of it down.

Mexico’s Tachoma Triumph

Nice job, Mexico!

In a significant public health victory, Mexico has succeeded in eliminating a disease which is the leading cause of blindness worldwide.

The Pan American Health Organization (PAHO) and the World Health Organization (WHO) announced Monday that Mexico is the first country in the Americas to eliminate trachoma as a public health issue. The disease, caused by a bacteria, affects the eye and repeated infections can lead to scarring and even loss of vision.

Mexico Eliminates Infectious Disease Which Is Leading Cause of Blindness” (Bethia Kwak, NBC News)