Why do we celebrate the birthday of the contraceptive pill?

I’m a 23 year old woman and am intrigued by the public’s relationship with the birth control pill. It was undoubtedly a huge step towards female empowerment through scientific innovation in the 60s, but now the pill seems to be something that we’re stuck with whether we like it or not. Despite its serious and vast ranging side effects, the pill is the most commonly used form of contraception in the UK. Meanwhile, the ‘male pill’ has been lurking in developmental stages for over 60 years. Why has scientific progress slowed so dramatically since the introduction of the pill? Contrary to celebrating it (and its inadequacies) year after year, we should be forging towards its improvement and embracing new alternatives.

The story begins in the 1950s when Margret Sanger convinced Gregory Pincus to begin work on creating a contraceptive. Initial tests on female rats in 1952 demonstrated that progesterone inhibited pregnancy. The work progressed rapidly, and in 1954, 50 women in Massachusetts underwent clinical trials for an early iteration of the pill. Two years later, in what was clearly an exploitative trial, the pill was given to 1,500 women in Puerto Rico, where a lack of legislation allowed the tests to go ahead. Side effects were noted and ultimately discarded, and the pill was approved by the FDA in the US in 1957 for use in severe menstrual disorders. Following a large number of women adopting its use, the pill was legalised as a contraceptive in 1960 in the US, and 1961 in the UK.

Hurrah! Science and policy have collaborated to produce and legalise a pill which gives women a choice over pregnancy. This part of the story is, I think, one of success, at least in certain lights. We’ve seen collaboration of a scientist and a women's rights activist, the rapid development of a drug, and its use to revolutionise the lives of (privileged and married) women at the time.

                 The 1960s pill packet. Image  here . 

                 The 1960s pill packet. Image here

But if the story stopped here it would be quite a boring one. What has happened since the introduction of the pill demonstrates a lackadaisical attitude from the scientific community towards furthering the development and knowledge of contraceptives.

Unsurprisingly, a drug that was created, tested questionably and adopted within 10 years came with its share of teething issues. There were many health scares that came about after the pill’s introduction; most notably, cancer. In fact, the chemical makeup of the pill has changed significantly over 60 years; one day’s dose of the pill in the 1960s is the equivalent of a whole week’s now. Imagine the assault on their bodies that these ‘empowered’ women would have experienced when adopting this medication fresh off the shelf. The problems with the original pill were so extensive that eventually, in 1988, the original pill it was taken off the market and improved alternatives took its place.

But even with historic and more recent improvements, the pill still isn’t perfect. Distrust and disquiet have been growing around the pill and its effects throughout the female millennial population. Just a handful of issues with the pill include: depression, anxiety, loss of sex drive, heavy periods, acne and a risk of long term infertility.

Yet, we fail to move towards an alternative. Conversations with friends verify my experiences. For me and so many others turning up to the doctors aged 16, the only contraceptive that was advised or discussed was the pill. On returning to report a problem with this method, the most common advice was to “try another pill”. The other options at our disposal are manifold: the coil, the IUD, newly developed contraception apps based on cycle tracking (now medically supported), condoms, female condoms and the diaphragm. Depressive side effects from the pill are common and are likely to stem from its hormonal function, but 2/3 of women aged between 20-25 still use it. Could this be the result of over-prescription and a lack of responsibility from GPs?

It is after all a doctor’s responsibility to prescribe an effective treatment for each individual, but things aren’t always this simple. Doctors themselves complain of the problems with prescribing birth control to women in rushed appointments. A key issue here is recognition of the power contained in these tiny pills. They have the ability to transform lives for better or worse, and therefore require at least a lengthy discussion prior to their adoption. This doesn’t seem to be recognised by the medical community at large, in fact, the pill is even prescribed to fix problems outside of its remit, such as acne and irregular periods. It seems like we should be limiting its use, rather than using it as a cure all. 


Women seeking birth control require some proactivity from individual doctors, who must use their time effectively to explore contraceptive options with patients, rather than prescribe according to the status quo. The education sector and public health campaigns alike should build awareness of new contraceptives, which could help to remove stigma around newer (often more effective and less emotionally invasive) alternatives. It represents a failing in the dissemination of scientific knowledge and healthcare information that there are many possible contraceptive options and yet women and girls alike seem to be oblivious to them.

Besides embracing the multitude of contraceptives on offer, there is another area where we really aren’t progressing. One particular contraceptive has actually been stuck in development since 1957.

It is, of course, the male pill. With work starting on this just seven years after that on the female pill, why has it still not made it to market 60 years later? 

      There are a plethora of methods to prevent conception

      There are a plethora of methods to prevent conception

The answer here is nuanced, obviously affected to some degree by the nature of those propagating the research, or allocating the funding. I am of course talking about men who often sit in a position of power, and for whom the male pill just might not be particularly attractive. Sarewitz and Woodhouse argue that science serves its creators: the rich and powerful, but could this also be the case in terms which genders research seems to favour?

However, men have been publicly calling for a male alternative to the pill for some time. Trials have started and stopped for almost as long as the female pill has existed. Irritatingly, men don’t seem particularly accepting of the side effects that contraception often brings with it. Trials on a male hormonal option have been halted after reports of effects on libido and general mood – side effects which definitely sound familiar to me, and did not stop me being prescribed the pill with wholehearted enthusiasm.

But the male contraceptives currently in development are showing promise. These are fully reversible injections to the vas deferens which prevent ejaculation. The method is being developed separately in two countries; the Indian version, RISUG, has been tested on humans for years and seems to be tantalisingly near completion, while the US's Vasalgel is still in animal stages. Hopefully this injection of enthusiasm into the development of the male alternative to the pill will translate into a legalised product before the pill’s 70th birthday. Although, the companies that make their billions from the current contraceptive solution have a vested interest in slowing this progress.

I have not tried to suggest that the female pill is bad or wrong for everyone, it does of course have its strengths. It's possible that male oriented research and a lack of innovation has resulted in slow progress in contraceptive research, but now we must focus on moving forward. Scientists, doctors and drug firms should not let themselves be lulled into celebrating the success of the pill over developing and propagating superior alternatives.

 

Direct to consumer genetic testing: what are you giving away in return for your genetic fingerprint?

Home genetic testing kits are a quick and easy way of finding out more about your DNA, but what are the real costs of this service? When you send off a testing kit, you’re not just agreeing to hand over money, you’re accepting the emotional impacts that the results could have on your life, and you might even be signing a contract that enables your genetic data to be used in any way the company sees fit.

In April 2004, the Human Genome Project (HGP) achieved its goal of sequencing an entire human genome. In fact, proudly displayed in the Wellcome Trust just around the corner are over 100 volumes that show the enormity of this scientific success. Yet, just four years after the completion of the HGP, pioneering scientific research became a public-facing, money-making scheme, and direct to consumer (DTC) genetic tests were hailed ‘invention of the year 2008’ by Time magazine.

                                                          Just a few of the volumes of the human genome at the Wellcome Collection

                                                          Just a few of the volumes of the human genome at the Wellcome Collection

DTC genetic testing companies such as 23andMeMyHeritage and Color make money from the public’s curiosity to discover their genetic fingerprint. Each company might have a different twist: some focus on inherited diseases, others find unknown relatives while some even purport to identify child geniuses in the making. I’ll be focusing on genetic health testing in particular, and the issues this raises.

Time magazine reports that the intentions driving 23andMe are to “learn and share genetic secrets”, these seem at first glance relatively pure. But regardless of initial intention, we must consider the possibility of such companies to do harm to particular individuals and the wider public.

To the unwitting customer, the appeal is obvious - genetic testing is portrayed as sexy, exciting, real life science. Websites use enticing hook lines, “23 chromosomes, one unique you”“Amaze yourself… with our simple DNA test”, and customers buy into the idea that they could learn something interesting about themselves. But what happens to these customers if they find out that they are carrying genes which give them an abnormally high risk of developing cancer, heart disease, Alzheimer’s or diabetes? One thing is certain, they won’t be getting help from their chosen DNA testing retailer. Providing support falls well outside the remit of 23andMe and its contemporaries.

             23andMe idealise their simple and hassle free method. Image  here . 

             23andMe idealise their simple and hassle free method. Image here

In the NHS, genetic tests are only used in cases where they offer a particular advantage, such as to diagnose, or predict a treatable disease. Incidentally, they typically come hand in hand with genetic counselling, because such information can have serious effects on the individuals and families in question. One thing is clear, a doctor is far more qualified to deal with the intricacies of these results than an FAQ page.

This raises the question of whether direct to consumer genetic testing is at all ethical. The decision to take a life altering test is trivialised by an online ‘click and go’ ideology. What’s more, the kind of predispositions that these tests can flag might be altogether untreatable, rendering the test entirely unhelpful. If an individual has a high risk of developing cancer but ultimately no way to reduce this risk, and no way to tackle the problem until it eventually (if at all) arises, then knowing their situation in advance will do them no good. It could even damage them psychologically.

Clearly, giving public the power to discover their unique DNA fingerprint is a huge, and potentially dangerous step. How is it that in just four years, this scientific process has been handed over unquestioningly to online retailers? This is a key difficulty of the scientific endeavour – once a breakthrough is published, there are very few sanctions on how it is used, or by whom. As a result of this scientific discovery, which has enabled huge medical breakthroughs, the population is now potentially at risk.

Yet these companies profiting from science and technology remain completely unregulated in the UK. There is currently no specific regulation on DTC genetic testing from the British government. In 2010, regulatory guidelines on DTC genetic testing were introduced by the UK Human Genetics Commission (HGC), but this arm of the UK government was discontinued after 2012 as a result of cost-cutting measures. That means that currently, DTC genetic tests have their run of the market, and zero culpability. Customers don’t interact directly with any medical professionals, nor administrative staff, so have no one to turn to if they have questions.

What may have looked like a fun idea now looks a lot less appealing. DTC genetic tests don’t enable the customer to learn about their DNA, they allow a faceless company to profit from poorly executed science and the potential disruption of consumers’ lives. 

Unfortunately, it gets worse. One paper reports that the contracts that ‘protect’ consumers' rights, often sealed via an ‘I agree’ tick box, are completely amorphous. These contracts give the customer no power, stating that they can be changed at any time with a simple update on the terms and conditions section of the website. Ultimately, each company with such a contract can do what they please with the genetic information of their customers. A contract is defined as a mutual agreement, but in reality, these clickable online contracts have their terms entirely dictated by one party, the service provider, and largely disregard the interests of the consumer.

So, as well as affecting your personal life, these companies have access to and, theoretically, sharing rights of your DNA. Suddenly, the lack of regulation graduates from worrying to terrifying. It is clear that the emotional and social consequences of DTC genetic testing are so great that these companies cannot continue to go unchecked. Scientists have created this technology, and now it is vital that the government controls its use.

As technology and science develop, their co-option into society grows ever faster. Scientists need to be increasingly aware that whatever they are creating will go on to be used out of their hands, and potentially out of context, by unknown entities. As Douglas explains, scientists have a moral responsibility to society which stretches beyond their research goals and towards its potential consequences.  As a result, conversations between scientists and regulatory bodies are vital, so that risks can be identified in advance. As science continues to innovate, the relationship between scientists and policy makers must grow closer in order to prevent such gaping holes in public safety.

Future Farm Lab Travels Vol. 2: Sophie 'Finding a Balance' / To Transylvania

This blog post marks the start of a new adventure: a summer spent working in rural Romania.

It’s easy to forget how important resting is, I think this is the biggest lesson I’ve learnt since starting my adventure with Future Farm Lab.

When we set out on our Future Farm Lab adventure a year and a half ago, I was addicted to action. I worked a full-time high tempo job, I wrote regularly for The Observer’s Tech Monthly magazine, I tutored Biology and Maths, and to add to this I now had many early morning and late night Skype and in person brainstorming sessions with my new but ever closer friends, Aspen and Phoebe. I had so much input coming from so many different sources that it was almost too much to take. Never a moment’s peace, never a moment to digest all that was going on in my life. But I loved it, at least for a short period of time.

As winter drew in I realised the damaging nature of my ways, I couldn’t sleep, I couldn’t relax, I was exhausted and anything could set me off into an angry rant or a flood of tears.

While Phoebe and Aspen made the decision to step back from the traditional working world and concentrate on Future Farm Lab, #OurField and their own personal projects, I knew that I needed to step back full stop.

I quit my job and I went on an extended and frivolous holiday - I learnt to dive, I road-tripped around Oman, I climbed up waterfalls and jumped off cliffs, and I even climbed to the second highest base camp in the Himalayas. My mum said I came back looking the healthiest she’d seen me in years. And for probably the first time in my life I had no trouble sleeping.

"My careful balance of rest, rehabilitation and now getting back into what connected me with Future Farm Lab has led me towards my next job

"My careful balance of rest, rehabilitation and now getting back into what connected me with Future Farm Lab has led me towards my next job

Since then it’s been a careful process of trying to refine balance in my life. For the past month I’ve back in London working casually and trying to learn new skills which will enable me to spread the message of Future Farm Lab’s learnings.

While I think our Future Farm Lab work is beginning to delve deeply into the specifics of agricultural science, I am currently feeling the need to reconnect with my initial reason for working together with Aspen and Phoebe. After some careful thought, I’ve remembered that this is to: distil scientific information and find a way to communicate this creatively. Therefore, as Aspen gets to grips with the experimentation side of solving our food cycle issues, I think I have learned to put some time towards what I think my skills are: communicating science to the public.

I’m lucky to have been given the opportunity to work alongside a previous supporter of Future Farm Lab, Guerilla Science. In the past weeks I have been the assistant producer of the science stage show: Intergalactic Travel Bureau. I loved the process of connecting with the public, performers and scientists in such an active and creative way. I was so excited by this opportunity as having tried my hand at professional writing, researching, running workshops and documentary production, I had never used a stage show as an opportunity to communicate science. (Look out for future developments, the show went really well and we’re having round-up reviews at the moment with ideas for how we can develop it for the future!)

My careful balance of rest, rehabilitation and now getting back into what connected me with Future Farm Lab has led me towards my next job:  I’ll be working in science education for 8 weeks in Transylvania. Here I will be leading a team of students in order to research and quantify the effects of farming method changes on local species diversity in this very remote corner of the world.

I’m very nervous but also excited, hopefully this next project will bring me back a step closer to the world of farming that I discovered with Future Farm Lab but keep the most important aspect of my work, science communication and education, very close to the surface.

When I return from Vampire country in September I’ll be back on the Future Farm Lab writing and workshop band wagon alongside a part time Masters degree and some further collaborations with Guerilla Science, but hopefully with a more healthy balance of rest and reward peppered in there too.

Aspen and Phoebe have been incredibly inspiring following the causes that make sense to them and giving me the time I needed to find mine, I’m definitely excited about more Future Farm Lab work in the future but am relieved we all seem to have found an individual niche within the world we’d all like to work in.

And, to round this blog post up with something a little more connected to agriculture, here’s a nice simile. The balance I’ve been slowly learning to cultivate is somewhat comparable to the balance that is so evidently important in our agricultural methods. While fields that feed us need fallow years, so do our bodies and our minds. Just as exhausted fields cannot produce nourishing crops, exhausted minds cannot by any means produce fruitful ideas.   

Stepping Stones: How Future Farm Lab Turned Into Much More

Future Farm Lab was setup to change the way we look at our food system and help the public to develop a newfound respect for farmers and the biological processes that take place behind every mouthful of food that we eat.

We identified that the food system is full of buzzwords - organic, sustainable, eco friendly, healthy, environmental, but very few descriptions of what any of these actually mean or how the farming process impacts these certifications.

Future Farm Lab aims to challenge this, and encourage consumers to explore the origins of their food. In order to spread the message we identified one of the most important places to be perhaps the inverse of what you might expect - places where scientists WON’T be. We felt that the science behind food production has for too long been shrouded in white lab coats, isolated from the general public, the time had come for three unconventional scientists to take science on the road.

And so Future Farm Lab was founded, early last year Phoebe worked at Imperial College, Aspen had just begun a PhD at Kings College and I worked in advertising and was a part time science journalist. We did our Future Farm Lab work by night and by early morning, frequently skyping at all hours in order to get applications done and ideas solidified.

Our first stop was a Crossmodalism workshop - held at the Proud Archivist (now Proud East) in Hoxton. Here we held three workshop stations and encouraged the audience to discuss and explore food science with us.

Following this we ran stations at Reading Science Fair, where we had the opportunity to work with children right up to adults and spark conversations about the status quo of food production.

Then the summer hit and we were awash with festivals - Shambala which Aspen took solo, Secret Garden Party which was approached as a team of 12 and Shambala, where Aspen and I ran workshops.

To finish off the busy summer, we curated a photography exhibition at Somerset House - where we showed our journey of food discovery through photographs, also showcasing Aspen’s groundbreaking work on cultured meat production. Aspen and I then finished the project by taking part in the Utopia talks, held at Somerset House.

The thing is that throughout all of this activity, we had been discovering things of our own. On top of all our events and exhibitions we took the time to read up on farming processes, and most importantly visit farms.

Perhaps the most influential of these was John Cherry’s farm in Hertfordshire, John is an experimental no-till farmer and really took the time to explain his practises to us and encourage us to look at farming and food production from a soil-centric view.

John’s approach made us appreciate the depth and intricacies in farming, which are so easily overlooked. This was a new kind of detail that we didn’t think we could portray in our traditional workshops - where we’d talk to the general public for anywhere from 1 minute to an hour. Largely as a result of our work with John, we wanted to start a new project that would be a longer process, but have the ability to make real shockwaves, changing the way that people view and interact with the modern food system.

We toyed around with the idea of inviting members of the public to buy into a cooperatively owned field of grain - in which the farmer’s decisions would be shared by the public, voting on the crops they grow, fertiliser applications and the place of sale. Inspired by the A Field of Wheat project - we gave this a go. With help from other founding contributors, we compiled a list of carefully selected co-investors for the first iteration we set up #OurField and ran our launch event on the 1st December at the Skip Garden in Kings Cross.

#OurField is a long process - a whole agricultural year is required for just the first iteration but we hope that this project can grow and spread to new communities with the help of the blueprint that #OurField will produce.

And what about us personally? Along this year we have all been varying levels of busy/stressed/freaked out. I think running Future Farm Lab alongside regular jobs made us all realise where our passions lie. Having waved farewell to conventional full-time jobs we are now all on a very different trajectory: Phoebe is currently living in Totnes and  running facilitation workshops, in February she will be visiting New Zealand as part of a project with Enspiral. Aspen is very shortly scheduled to fly out to Canada to concentrate on her lab work and visit some groundbreaking farmers on the way. I also have plans to travel and am shortly flying to Central America to travel and volunteer on permaculture farms and conservation organisations.

In such a short time, Future Farm Lab has developed and transformed. We still stand by our principles that originally founded us but our love of science collaboration and communication has led us all to opposite ends of the globe for now.


We’ll be re-convening in the UK come summer where we hope to run some more festival workshops, sharing everything we have learned, will harvest the #OurField crop and will be visiting more groundbreaking UK farmers and disseminating the information they give us.