Category: Why We Fight

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.

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Feed Yourself; Feed Some Other People

Norma’s is one of my favorite restaurants of all time, anywhere in the world. So if you happen to be in North Oak Cliff, in Dallas, near the Bishop Arts area, stop in and get you some food—pies, veggies, coffee, chicken-fried fill-in-the-blank, it’s all good. You’ll be helping homeless kids (particularly on June 15), but the person you’ll really be doing a favor is yourself.

Eat at Norma’s, give a homeless kid a birthday party” (Rachel Stone, The Advocate)

Pledge of Allegiance

I’ve been seeing a grumpy meme mocking “the far left” for their preoccupation with racism, as though it’s an insult invented by unpatriotic extremists to beat up Real Americans(TM). I seem to recall that every weekday for 13 years I was instructed to recite a loyalty pledge in which I promised, hand on my heart, to defend liberty and justice for all. All. Maybe you’re familiar with it.

These colors don’t run, y’all.


Gary says: That dog hunts! Always has!! What’s tough for some hunters is that they sometimes realize THEY are the hunted.

Jeff says: A mandatory loyalty pledge in any free society is odd, as is the entire notion of having to repeat any pledge daily, but the “liberty and justice for all” part is really good.

Gary: I don’t know that I would call it mandatory, although when children are required to recite the pledge, it might be called “brainwashing.” But to me, it is brainwashing in a good way! It’s only mandatory in the military, or of those who serve us in the government, as it should be.

Romie: I always thought it was kinda weird, and none of my schools bothered people who didn’t want to do it. I usually participated, although at different points I dropped out certain bits (because my allegiance isn’t actually to the flag; because I believe in a separation of church and state; because the nation was divisible [I felt at the time, but now I take the Unionist point of view that the Confederate secession was never legally legitimate]).

I have a lot of sympathy for people who find the pledge sinister or alienating. However, speaking only for myself, I enjoy rituals and mantras. There’s something interesting about returning to the same set of words over and over again and finding that I understand them differently. Particularly when they’re words I share with a lot of other people.

Sharon: Seconding the enjoyment of rituals. I worry sometimes my daughter doesn’t get enough of them. She, like me, is a creature who enjoys habit.

Kathy: Hate is never good.

Festa della Repubblica

By the way, today is the Festa della Repubblica, the Italian national day. It is, as you can tell from the name, NOT unification day, when Italy became one country. It’s a celebration of when — in 1946 — Italy voted to become a republic, and formed the current government after WWII.

This was not a foregone conclusion. There were 12.7 million votes in favor of forming a republic. There were 10.7 million in favor of restoring the monarchy.

It makes sense. When the king ceded power to a popular government, that populist government was Mussolini’s Fascists. There was not a great track record with non-kings. Particularly in the south, there was a desire to go back to the way things had been, which included festivals with nice desserts. They didn’t have the benefit of knowing what we know today, which is that a republican Italy has many festivals with nice desserts.

But Democracy won. The country made a brave decision and formed a parliament. It would from that point forward be the duty of the people to protect the people. Which they have done. This is verse three of the national anthem they adopted a few months after the vote:

Uniamoci, amiamoci,
l'unione e l'amore
rivelano ai popoli
le vie del Signore.

Let’s unite and love one another. Unity and love reveal to the people the ways of the lord.

Bravi, italiani.


Nic says: I dream of the day when we can have a referendum about our monarchy… Even if it wasn’t consigned to history’s dustbin, it would be a huge step to even have it.

Chicca says: Those were very violent times, though. Italy got there and sense prevailed, but there was so much animosity against the King and between his supporters and those against. Glad, of course, we’re well over that now, but Italy is starting to forget its own moral centre, the constitution and how we actually are supposed to help one another and any one in need that makes Italy their new home. It’s a day to celebrate and a day to make us remember what we should be like.

Billfold Essay About Italian Austerity

New essay by me at The Billfold, “Social Trust in a Cash Economy” — a collage of cultural anecdotes about Italy and money, and the way a very calm Austerity crisis feels. It’s about a six-minute read. It starts like this:

There is a recurring bill I pay in Italy, in person, with a credit card. When I finish the transaction, the secretary makes a handwritten note in a small book. She makes the same note on a card-sized piece of notebook paper which I carry. One time, I forgot to bring the card-sized piece of paper. The secretary urgently retrieved an identical card and wrote down the entire history of our financial transactions, so that if she ever tried to cheat me, I could say, no, look here, in your handwriting it says I paid, because this ballpoint numeral is more meaningful than a credit card statement.

Something I didn’t know when I wrote the essay (because I just found out about it today) is that Italian banks get robbed a lot. A lot a lot a lot. (In the essay, I don’t write about banks at all, which probably wouldn’t have changed. But by coincidence, the essay came out the same day I knew this new thing.) Between 2000 and 2006 (the last timeperiod for which there is comprehensive data), Italian banks were robbed an average of 2771 times a year. That’s “walked in with a sack and robbed” robbed. For comparison, Germany’s number is 838. Spain’s is 523. Greece’s is 144. It is a pain in the ass to go into an Italian banks, with lots of, essentially, nested delayed airlocks you have to pass through solo. I figured this was the usual Italian security mania, but in this case it seems warranted

To the Teen Girl Targeted on the Portland Train

Teen Targeted On Portland Train Thanks Strangers (CNN)

Oh, hon. I know I’m talking to my TV and you can’t hear me, but I am talking anyway. Sad girl, it breaks my heart to hear you say, “They lost their lives because of me and my friend.” They lost their lives because a violent, angry, confused man wanted to kill them. Their last wish, their dying wish, was that you and your friend feel welcome and safe and valued. I want that too. I hope somebody nearer by can tell you. I hope everybody can tell you, over and over, until you have been told enough times that you are able to believe it.


Angela says: It’d be cool if the president said it, or in any way acknowledged it, instead of amplifying the message that she’s a problem.

Romie: I don’t think of us as having a president right now, since the guy elected to the office doesn’t seem to want to take the role on. We’re going to have to fill in as best we can. For instance, although I don’t have the statutory powers, I’m going to do what I can to be president, and to represent all of us and the best of our hopes. Please join me in also being president.