“Plan B,” which is a form of pregnancy contraception, is available in almost every country in the world. In most countries a prescription from a doctor is required to purchase the pills involved, but in many countries, the woman or girl who wants the pills can buy them “over-the-counter” without a prescription.
Recently, in the USA, Kathleen Sibelius, Secretary of the Department of Health and Human Services, negated an order by the FDA (Federal Drug Administration) to allow any girl, regardless of age, to buy Plan B pills without a doctor’s prescription.
This intra-governmental fighting produced a controversy in the USA with many people completely unaware of what Plan B was and why girls could not buy it without a prescription.
BLOOD SUPPLY OF PELVIS
I, personally, received many calls from patients who were parents of young girls, asking for explanations. This is one of the reasons why I am writing this article.
WHAT IS “PLAN B”?
In order to understand Plan B, it is necessary to understand a little about the female menstrual cycle.
The Menstrual Cycle is a very complex interaction between the brain, the pituitary gland and the entire female reproductive system. Many doctors, unfortunately, have forgotten the exact details of how the cycle works. Most of the public have absolutely no idea of this complex interaction between tissues, hormones and that part of the brain called the “Hypothalamus.”
I am going to simplify the actions and reactions involved, but I must warn the reader that the terms used have many different forms, depending on whether we are talking about synthetic hormones or the real hormone.
For example, Progesterone, a hormone produced in the ovary and also in the adrenal gland has many synthetic forms, mostly using
the prefix “progestin.”
The underlying mechanism or goal is quite simple: The user of these pills wants to stop “OVULATION.”
Ovulation, of course, is the release from the ovary of the “egg” which, if fertilized by a sperm, will ultimately become a complete human being. In certain religions, the prevention of the release of the egg from the ovary is considered “unnatural” and is forbidden.
Most religions, and most governments permit the use of hormones to prevent this release. The pills used are called “Birth Control Pills.” The hormone used is called Progesterone.
Progesterone acts by blocking pre-hormones in the hypothalamus, the area of the brain that controls the Pituitary Gland. This blockage
in turn prevents the Pituitary from releasing two hormones: Follicle Stimulating Hormone, which stimulates the egg to grow, and Luteinizing Hormone, which causes the egg to come out of the ovary.
By keeping the egg inside the ovary, we prevent pregnancy. This entire process is called “Contraception” or “Against pregnancy.”
Here is a diagram of this “Negative Feedback”:
- High levels of estrogens suppress the release of GnRH (bar) providing a negative-feedback control of hormone levels. It works like this: Secretion of GnRH depends on certain neurons in the hypothalamus which express a gene (KiSS-1) encoding a protein of 145 amino acids. From this are cut several short peptides collectively called kisspeptin. These are secreted and bind to G-protein-coupled receptors on the surface of the GnRH neurons stimulating them to release GnRH. However, high levels of estrogen (or progesterone or testosterone) inhibit the secretion of kisspeptin and suppress further production of those hormones.
- High levels of estrogens suppress the release of GnRH (bar) providing a negative-feedback control of hormone levels. It works like this: Secretion of GnRH depends on certain neurons in the hypothalamus which express a gene (KiSS-1) encoding a protein of 145 amino acids. From this are cut several short peptides collectively called kisspeptin. These are secreted and bind to G-protein-coupled receptors on the surface of the GnRH neurons stimulating them to release GnRH. However, high levels of estrogen (or progesterone or testosterone) inhibit the secretion of kisspeptin and suppress further production of those hormones
WHAT ARE THE DANGERS?
If the process of contraception proceeds as planned, there are no serious dangers except that of an allergic reaction and other side effects. However, in this particular universe, very little goes “according to plan.”
According to statistics by many governments Plan B has only an eighty percent chance of preventing pregnancy. Thus, one out of five girls or women who use the plan will still become pregnant.
This is serious in the sense that many women believe that Plan B is a certain way of preventing pregnancy when, in reality, it is not. Therefore, these women place themselves and their unwanted child in a dangerous situation which can only be rectified by abortion or delivery.
More importantly is the danger of an “Ectopic Pregnancy.”
WHAT IS AN “ECTOPIC” PREGNANCY?
In a normal pregnancy, the fertilized egg implants itself in the uterus and, under normal conditions, goes through the full developmental stages and terminates in a normal delivery.
Of course, there may be many problems with this entire process, and an entire field of medicine, Obstetrics, devotes itself to these
But, the Ectopic Pregnancy is the one area that is extremely dangerous. An “Ectopic” pregnancy occurs when the fertilized egg implants itself, not in the uterus, but elsewhere—generally in the Fallopian Tubes.
Two out of one hundred pregnancies, are “Ectopic Pregnancies.” Ninety five percent of ectopic pregnancies are found in the fallopian tubes. The rest may be anywhere, including the abdomen itself.
Prior to modern surgery, almost all of these women died from the complications resulting from not being in the uterus.
The ectopic pregnancy is so dangerous that in my clinic I have standing orders that any female of any age must have a pregnancy test if she complains of pelvic pain. (The reason I use any age is to cover that area of doubt, She’s “too old” or “too young” to be pregnant. I don’t want lazy technicians using that excuse for not doing a test that takes five minutes. I never charge for this test.)
The reason I am so worried about an ectopic pregnancy is the almost inevitable event that the ectopic pregnancy will “rupture.”
A “RUPTURED” ECTOPIC PREGNANCY
If a pregnancy has occurred in fallopian tube, the embryo continues to grow as though it were in the uterus. But the fallopian tube cannot withstand such growth. Eventually, the enlarging embryo causes the fallopian tube to tear apart or “rupture.”
The blood supply in that area of the body is enormous. One can imagine that enough blood flows to the uterus to support an entire pregnancy. There are also the arteries and veins that go to the legs, intestines, bladder and other vital organs.
Suffice it to say that a rupture ectopic pregnancy leads to death within a short period of time.
I remember the case of a doctor who was called in the middle of the night by a young girl who had pelvic pain. She had obtained birth control pills from another doctor and told her family doctor this information. The family doctor replied “if you’re still having pains in the morning, go to the doctor who prescribed you those birth control pills.” The girl never awoke in the morning. She was dead.
The family doctor was sued for millions and he lost the case and almost lost his license to practice medicine. He should have either gone to see her immediately, or he should have sent her directly to the nearest emergency room for tests and immediate surgery.
Every ectopic pregnancy should be treated as soon as it is discovered. The Plan B pills may hide the fact of an ectopic pregnancy.
Although an abortion of a fertilized egg or small embryo is not necessarily dangerous, for some people it is a religious sin. According to the medical literature, this does happen, but rarely. Even though it occurs rarely some people refuse to use Plan B for this reason.
A SENSE OF FALSE SECURITY
Plan B is never as good as Plan A. If you do not want a pregnancy, the best method is complete abstention. However, we all want something without paying for it. Therefore women expose themselves to pregnancy, hope for the best, but if a mistake occurs they try Plan B.
As we have seen, statistically one out of five women using Plan B, will become pregnant.
Twenty percent is a high percentage. This high percentage is present even though under natural conditions many couples cannot achieve pregnancy even though they actively try. These infertile couples make the twenty percent higher.
According to the studies in infertility, 12 percent of couples who want children are infertile. This means that risk of pregnancy is 12 percent higher than the oft quoted 20 percent. If we only talk about fertile couples, the risk goes from one out of five to one out of three!
The part of the false sense of security problem that is most damaging is that many older men tell young girls that they have nothing to fear because: “There is always Plan B.” Many young girls fall into this trap and are abused.
Like smoking tobacco or other dangerous habits, exposure to pregnancy will always be present in society.
The Plan B option does not solve the problem, and frequently makes it worse.
One can only hope that education and governments that are not controlled by pharmaceutical corporations will move more to a situation where help for girls and women are instantly available and Plan B’s become unnecessary.