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Western Carolinian Volume 62 Number 07
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®Ij£ He0t.ern Carolinian Features Thursday, September 2619% 5 The Depo-Provera Revolution ANN WRIGHT FEATURES EDITOR Commentary Most people have heard about the contraceptive shot a woman can receive once every three months. It eliminates the need for a good memory required by the Pill and provides almost foolproof protection against pregnancy. But does it really live up to its reputation? Depot medroxyprogesterone acectate (Depo-Provera) has been around since 1966. An estimated 30 million women in over 100 countries have used Depo-provera as an alternative to the Pill and contraceptive inserts. Numerous studies have shown that the failure rate of Depo-Provera is less than one pregnancy per 100 users per year. Because of its effectiveness and comparatively easy use, Depo-Provera is especially favored in developing countries like China, where overpopulation is a great concern. However, the U.S. Food and Drug Administration did not approve its use until 1992—25 years after the manufacturer, Upjohn, first applied for its approval. Before addressing the fears which held back the FDA's decision and which still persist, let's take a look at the benefits of Depo- Provera. Benefits Depo-Provera injections do not introduce chemicals foreign to the body. The main component of Depo-Provera is progesterone, a hormone found naturally in a woman's body. Progesterone plays a crucial part in the gondotropim secretion before ovulation and after the ovulatory cycle is completed. Progesterone acts in three ways. First, it begins the release of gonadotropins. It then enables the release of follicle-stimulating hormone (FSH). Progesterone also limits to one day the amount of luteinizing hormone (LH) released into the body. This hormone is necessary in the process of conception because it affects the release of gonadotropins and helps to control ovula tion, which falls between menstrual cycles for most women. Depo-Provera consists of 150 mg of progesterone per injection. This injection, which should be given either on or between the first and fourth days of menstruation, delays ovulation for fourteen weeks. Depo- Provera users receive an injection every twelve weeks. This lack of ovulation also produces another benefit in nearly 80 percent of users: no monthly periods. This attribute is especially helpful to women who suffer from anemia. Depo-Provera is one of the most effective birth control methods next to sterilization. For most birth control methods, effectiveness ratings reported by manufacturers are several points higher than their actual effectiveness. For instance, condoms at best have an actual effectiveness 90 percent; even when used correctly, they occasionally break or leak. Spermicidal inserts (including films, foams, suppositories, and gels) have an actual effectiveness of somewhere in the mid-80 percent range, depending on the product. Spermicidal inserts often fail because most require a ten- to 15-minute wait after insertion before intercourse can begin. Used together, condoms and spermicidal inserts containing Nonoxynol-9 are supposed to be as effective as the Pill. . Many people, though, find using even one kind of contraception a great inconvenience, no matter what trouble it saves in the long run (i.e., pregnancy and STDs). The Pill has an actual effectiveness of between 97 and 98 percent. However, if users forget to take the Pill for two or more days, the chance of getting pregnant actually increases over not using anything at all. Depo-Provera requires only a two-week waiting period after the first injection to insure full potency (a back-up method, such as a condom and a spermicidal contraceptive insert, should be used during this time). Its actual effectiveness is greater than 99 percent. The only 100- percent effective method of birth control, aside from abstinence, is sterilization, which has permanent effects and the threat of tubular pregnancy. Also, there is the rare case of a woman's fallopian tubes growing back together years after tubal ligation. The effects of Depo- Provera are reversible. If a woman using it decides to get pregnant or cannot handle Depo-Provera's effect on her body, she only needs to stop going in for injections. Injections are also reasonably painless. They are given in either the upper arm or the buttock. Users of Depo-Provera usually do not experience the worst side effects of the Pill. While Pill users often face nausea and vomiting, Depo-Provera users have not identified these as problems. Depo-Provera is fairly cheap. The average cost of one year's worth of injections, plus the amount the doctor charges for giving the injections, is around $200. However, for those would-be users who have low incomes (as most college students do), gynecological exams and Depo-Provera injections are free or offered at a reduced price through the local health department. The World Health Organization (WHO) found that Depo- Provera usage decreases a woman's risk of getting endometrial cancer. Depo-Provera is also almost worry-free. Whereas the pill requires everyday thought, and condoms and spermicidal inserts require consistent usage every time a person has sex, Depo-Provera users only need to remember it once every three months. In fact, Depo-Provera is good for more than just contraception. The January-February 1993 issue of Health reported that Depo-Provera injections are increasingly being used to treat male sex offenders, such as pedophiles and rapists. Since Depo-Provera imitates the female hormone progesterone, it diminishes men's sex drive and lessens their ability to perform sexually. This product seems almost too good to be true; perhaps it is. There are several unfavorable side effects which may go along with usage. Drawbacks Many Depo-Provera users have experienced headaches, mood swings, weight gain of two to four pounds per year, slight hair loss or growth, and dizziness, though these side effects sometimes disappear completely after the first few injections. Though a stopping of menstruation was listed under "Benefits," many women find this unsettling. Monthly periods can provide a woman with a sense of relief that she is not pregnant and that everything in her reproductive system is physically okay. Aside from these manageable, temporary side effects of Depo-Provera, there are a few side effects which might cause an irreversable outcome: death. Depo-Provera provides no protection against sexually transmitted diseases like hepatitis, gonorrhea, and HIV. Many women only feel comfortable using Depo-Provera as a means of contraception, using a latex condom for protection against disease. Your current partner(s) may be disease-free and completely faithful; however, as the old cliche goes, "When you sleep with a person, you're sleeping with every person they have ever slept with and with every person those other partners have ever slept with." Scary, isn't it? STDs do not care about sexual orientation, education, age, race, or socio-economic class. In fact, heterosexual women in their 20s now comprise the fastest-growing group of those infected with HIV; many women are forgoing latex condoms because they are on the Pill or get regular Depo- Provera shots. New research indicates that Depo-Provera use may increase a woman's chance of contracting an STD. At the Aaron Diamond AIDS Research Center in New York, 28 female monkeys were vaginally exposed to SIV, the simian equivalent of HIV. Eighteen of these monkeys had been receiving regular injections of progesterone birth control devices, one of which was Depo- Provera; the other ten monkeys were injected with a placebo. Fourteen of the 18 monkeys who had been receiving progesterone injections contracted SIV. Only one of the group that had received the placebo contracted the virus. The hormone thinned the vaginal wall, which allowed SIV to get into the bloodstream. This data could indicate a death sentence for women who go on Depo-Provera because they like to have multiple sexual partners whose contraception choices vary—not to mention those women who believe that they are in a mutually monogamous, disease-free relationship. If a woman is in a monogamous, disease-free relationship and can deal with the occasional side effects, is she a perfect candidate for Depo-Provera? Yes and no. There is one other possible side effect of the injection. The FDA held back approval of Depo-Provera after Upjohn first submitted it in 1967, because it had a disturbing effect on the beagles used in testing: many test subjects started developing breast rumors. By the '90s, studies performed on women in other countries indicated no increased occurrence of breast cancer between women who had received Depo-Provera and women who had never received the injections. Beagles were also proven to be unsuitable models for humans since hormones affect them in different ways. The FDA finally relented in 1992 and approved Depo-Provera for use in the U.S. Since then, many studies have been performed, and no real correlation has been found between the use of Depo- Provera and women getting breast cancer. However, there are still unresolved questions. Results from two similar, widespread case-control studies conducted on women in New Zealand, Thailand, Mexico, and Kenya were pooled. In this combined study, researchers found that women who had begun using Depo-Provera within five years of the study were twice as likely to have breast cancer than women who had never used the product. Women under the age of 35 were in the highest risk group. However, when researchers looked at the numbers of women who had ever used Depo-Provera, there proved to be no increased risk. This data indicates that Depo-Provera does not increase a woman's chances of getting breast cancer. Then why were the women who had received Depo-Provera within five years of the study at a seemingly higher risk for breast cancer than other women? Researchers have two explanations: (1) Depo-Provera may accelerate the growth of already present but still undetectable tumors. (2) Women who receive Depo-Provera injections usually. receive breast exams, which increases the likelihood of detecting tumors in the breast as opposed to women who do not receive breast exams. No study or counselor can really tell a woman whether or not Depo-Provera is right for her. That is a personal choice which must be made after a great deal of consideration on the woman's part. Whether this drug has the potential to produce dangerous side effects is still up for debate. Last Minute Productions & The Ramsey Center Welcome *<S 0\ O* .THE Samples I— with guests JUMP LITTLE CHILDREN toteR_-n^ (-enter Friday October tlth 8:00 pm tickets on sale NOW at the Ramsey Center and ai other usual ticket locations! WCU students $2-50 groups $U.50 ai others $17.50 '* al seats reserved •ALL TU<__TS DAY OF SHOW $17.50 for ticket info cal 704-227-7206 or■704-227-7722 Skateboarders Ask for Space SCOTT FRANCIS STAFF WRITER Everyone has seen cars plastered with stickers bearing the slogan "Skateboarding Is Not a Crime." This is a common outcry made by skateboarders concerning the negative image attached to the sport. Understandably, skateboarding is often barred from busy public places for safety's sake. In some cases, however, arrangements are made to accommodate the population of skateboarders and provide them with a place to skate, such as a skate-park or a time slot when skating is allowed. WCU's campus is not skateboarder-friendly. Though rollerblading is allowed just about anywhere, skateboarding is confined to the far regions of the baseball parking lot. Many students would like to see this policy changed. Brent Hobby and Cris Weatherford are two such students. They have been skating for a substantial amount of time and consider it a big part of their lives. "I'm 23 years old; I've been skating ten years. It's never been a fad for me," says Hobby. Both Hobby and Weatherford are used to more skating freedom. Weatherford is from Charlotte, where, he claims, skateboarding is more accepted. "There's a lot of street-style skating and a couple of parks just opened up," he says. Hobby says, "I've skated all over North Carolina, particularly in the Raleigh-Greensboro-Chapel Hill area. It's a lot more tolerated there than it is here. People are willing to accommodate you as long as it's at an appropriate time. There are also more public places to skate." While one may argue that WCU provides skateboarders with a designated skating area, the terrain must be considered. The baseball parking lot is flat, and students are not allowed to use any ramps or obstacles when skating there. It hardly offers skateboarders the freedom to really skate. "You can't put skateboarding in a box," argues Hobby. "If they want us to confine it to one area they should let us use ramps and obstacles." With the baseball lot as their only legal option, many skateboarders choose to ignore the campus policy against skateboarding. They are often quickly spotted and reprimanded by campus security. Many try to escape security by skating away when they see them coming. Others stand their ground and usually get off with just a warning. "I just talk to them," says Hobby. "Most of the campus police are nice about it, or at least courteous." Weatherford adds, "It's not their fault. They didn't write the policy. They just do their job. Running from them is stupid—there's no point in running if you're not doing anything wrong." Many skateboarders find it unfair that rollerblading is tolerated on campus while skateboarding is not. Neither Hobby or Weatherford condemn rollerbladers for seeming to get away with what they can't. "I don't have anything against them," says Weatherford. "They get to do their thing, and that's rad. I wouldn't want to see a negative solution [such as rollerblades confined to the baseball lot]. I only want everyone to be able to skate." Hobby and Weatherford keep hoping for some change in the skateboarding policy. "I would like for them to establish a time-slot or something," says Weatherford. "It's not like were dumb enough to skate in the middle of afternoon traffic." "Mostly I want people to recognize that skateboarding is not a negative thing," says Hobby. "True skateboarders in general are unique and sincere. They have a passion for what they do that is unparalleled to anything. It promotes individualism and creativity. You don't need a team to do it; it's internal. If there was one word to best define me, it would be 'skateboarder.'"
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The Western Carolinian is Western Carolina University's student-run newspaper. The paper was published as the Cullowhee Yodel from 1924 to 1931 before changing its name to The Western Carolinian in 1933.
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