If we are going to be concerned about synthetic human estrogen in our water, we also need to pay attention to other likely culprits, and both industrial and agricultural sources need to be considered.
I find it troubling that we have dramatized the contribution of estrogens in our environment to women on the pill. I’m not suggesting we should ignore the impact of estrogens in our environment. In fact, quite the opposite. Clearly, the types and sources of estrogens in the environment are diverse and cumulative. Natural estrogens (agriculture and natural human excretion) as well as synthetic estrogens and estrogen-mimicking compounds (other pharmaceutical uses, industrial chemicals, pesticides, plastics, etc) are present in our waterways and cannot be discounted as sources of the observed phenomena in fish, even at trace levels. What I am suggesting is that we stop the knee-jerk response that reducing estrogens is as simple as reducing women’s use of birth control pills. It is estimated that unregulated agricultural run off annually contributes 13 tons of hormones to our water sources. Clearly, we need to broaden the conversation.
What else can we do? First, we need to reform our chemical policy in the United States so that harmful estrogen-mimicking compounds found in our everyday products stay off the shelves. The burden cannot and should not be on individuals and communities to protect the health of their families. Instead, we need reform that requires pre-market safety testing of all our consumer goods and personal care products. Second, as the 50th anniversary of the pill is on the horizon, I’d like to ask my friends and allies to take some time to appreciate and even celebrate contraception. Modern contraception enables women to choose the number and timing of their children, which is central to our health and economic well-being. And, where all women have access to affordable contraception, birthrates decline and population growth slows. Slower population growth is not a panacea for today’s environmental problems, but it can ease pressure on natural systems that are reeling from stress. So, contraception is good for women—and for the planet.
In the meantime, we might think about forgoing that next hormone-riddled bacon cheeseburger.
References: Callantine MR, et al. "Fecal elimination of estrogens by cattle treated with diethylstilbestrol and hexestrol." Am J Vet Res. (1961) 22:462-465.
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It is true that human exposure to chemicals
in our every day environment deserves more attention. A growing body of scientific
evidence indicates that
chemicals in our environment are negatively affecting male and female
fertility as well as the health of the developing fetus. More and more
reproductive health, rights and justice organizations, advocates, and health care providers are calling for research that will enhance
our knowledge of this issue and on reforms that will minimize our exposure
to harmful chemicals. Reproductive Health Technologies Project
is committed to the effort.
But this is an extremely complex issue.
While there is evidence that estrogenic contaminants in the environment
are having a negative impact, there is no evidence that oral contraceptives
are the main culprit. There are many other estrogenic drugs in
the environment - including hormone replacement and estrogen mimics
that are used for chemotherapy. In addition, industrial chemicals that
can mimic hormones such as those found in detergents are also estrogenic.
We are aware of only one study that focuses exclusively on the impact of the specific synthetic estrogen (17α-esthinylestradiol, commonly called EE2) contained in some oral contraceptives (many oral contraceptives do not contain EE2). But in this study, EE2 was tested in its "pure" form, not as it is released in a woman's urine. The Vatican's effort to disparage contraceptives misses the larger picture -- we need better water treatment systems to get rid of ALL the chemicals.
Naturally the Vatican's analysis also fails to acknowledge the benefits of contraception to reproductive health and the environment. Most mainstream scientists agree that the human impact on the environment is the most detrimental. Contraception has enabled women and families to decide when and how many children to have and this in turn has been show to improve the health of children, women, communities and the planet. The Vatican's overstatement of this science is just the most recent twist in their decades-long rejection of safe, effective modern methods of contraception.
But there is a lot we can and should do, including:
We urge the Vatican to join us in these efforts -- efforts that will move us in the direction of protecting the environment and our fertility.
]]>As I approach my 30th birthday, having delayed marriage and children, the social and biological clock of keeping time for childbearing ticks louder. However, thanks to another 30-year-old woman, it's possible for me to feel at ease. That woman is Louise Brown, the first child born via IVF. Last week marked not only her 30th birthday but thirty years of success in giving many women and men a second chance to have a biologically-related (at least, in part) child of their own. In fact, over 3 million babies worldwide have been born using IVF -- with over 52,000 infants born in the US, accounting for 1 percent of all births in the country.
In conversations with my close friends, it's been comforting to hear that we share the same concerns about starting a family later in life. We joke that after years of being on birth control--from condoms to pills to patches and rings and back to condoms again--diligently trying to avoid an unplanned pregnancy, we're fearful that we may, in fact, experience infertility.
Because of assisted reproduction and the tremendous successes gained in the past three decades, the clock is not ticking as loudly for me as it was for my mother. Instead, my generation has grown accustomed to this $3 billion industry--most of us know at least one friend, family member or colleague who has been through IVF. But this familiarity brings with it a whole new set of concerns. What are the ethical, moral, legal and financial impacts of this field? How do we grapple with these issues as a women's community, before others tell us what's best for our bodies and for our children? We've seen it before, and it will happen again.
It is incumbent upon the women's reproductive health community, particularly those who face these issues daily, to foster this debate. We might begin with the following concerns:
Number 1: Why is my generation of women and men more infertile than our parents? Currently, in the US, 1.2 million (or 2%) of women of reproductive age (defined by the CDC as age 10 to 49) have an infertility-related medical appointment each year; 10% receive infertility services at some point in their lives. As I've alluded, a big factor is age. To simplify things greatly, as more women gained equality in education and in the workplace, we also began to delay childbearing--for many reasons, including lack of maternity leave and inflexible work schedules.
But to highlight only age would be misleading. With so many individuals experiencing infertility (and in cases in which the underlying causes are never found), we cannot ignore the tremendous role that environmental contaminants are playing in this problem. Exposure to ubiquitous dioxins, such as cigarette smoke, lead, mercury and some agricultural pesticides are direct threats to a couple's ability to conceive or have a healthy pregnancy. And, more troubling, new research suggests that a broader range of chemicals--including many that are associated with everyday products such as household cleansers, flame retardants, personal care and beauty aids, and even plastic water bottles--could have a complex and far-reaching impact on fertility.
Number 2: Are these procedures--the hormones, the retrieval of eggs, the implantation of one or multiple embryos--safe for women and their children? The answer, for the most part, is that we don't know. While IVF has generally been accepted as safe by the American public, there are in fact very little published data, let alone quality, standardized data, on the short and long term safety of these procedures on women and children's health. As we see an increase in women going through these procedures for either their own reproduction or to donate their eggs, how can we fully inform them of the potential risks and benefits?
Number 3: The growth of this industry and the growth in the numbers of assisted fertility clinics (now at 475 in total) have increased the demand for women's eggs. While most clinics offer women an average of $3,000 to $8,000, some "baby brokers" have offered as much as $50,000-80,000 for specific egg donors. (The American Society for Reproductive Medicine's (ASRM) guidelines allow for women to be compensated for their time and risk up to $5,000 or $10,000 in some cases, but this is neither mandated nor regulated by either state or federal law.) This issue poses its own ethical and moral dilemmas: should a woman be compensated for donating her eggs? Can payment create a coercive or exploitative situation? What are the race and class implications of who demands and who gets solicited for their eggs?
As with many momentous events in my life, as I approach my 30th birthday, I'm asking myself more questions than I know answers. I have found that asking questions--and listening to a broad range of voices who have their own personal and insightful answers--is the first step in the process in advocating for change. We must grapple with these issues and then propose solutions that follow our values and morals. So, in that vein, my parting question: what policies will empower all women to make their own decisions about having a child and yet protect her health? The answer to this will be the best 30th birthday present for me and Louise.
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