Do you know what's in your hormonal birth control?? I investigated to find out!

Updated: Apr 15, 2020



Birth control and contraceptive use have influenced the world in many ways, especially for the lives of women. There are many contraceptive options available to the public, including hormonal and non-hormonal methods. By conducting a Life Cycle Assessment, the individual, social and environmental impacts of hormonal contraceptives will be explored. It is imperative to uncover these impacts considering that hormonal contraceptive options critically outweigh non-hormonal options, 15.9% of women (in America alone) aged 15-44 currently use the hormonal pill, and approximately 18% of the world’s contraceptive users choose a hormonal one (Center for Disease Control and Prevention, 2016).


Resources

The ingredients used in hormonal contraceptives include some form and combination of the synthetic hormones estrogen (ethinylestradiol) and progesterone (progestin)(Kuhl, 2005). Each brand differs in dosages and hormone combinations. Other inactive ingredients in hormonal contraceptives may include sugar, iron, dyes, water, corn starch, magnesium stearate, lactose, croscarmellose sodium, polyethylene glycol and titanium dioxide (Harding, 2017). The hormones used in hormonal contraceptives are natural or synthetic compounds derived from either animal sources, phytoestrogens (plant sources), or xenoestrogens (chemical sources)(Pradhan, Mishra, Panda, Behera, Jha, & Choudhury, 2013).


Hormones derived from animal sources are extracted from the urine of pregnant female horses (Shumaker et al., 2004). Other animal-derived sources are un-identified by the Federal Drug Administration. Phytoestrogens are sourced from plants that naturally carry significant amounts of the estrogenic compound including nuts and oilseeds, soy products and legumes (Pradhan et all, 2013). Xenoestrogens are man-made substances derived from natural chemical compounds found in plants such as soy or are created from synthetic chemical compounds such as PCBs (polychlorinated biphenyl), BPAs (Bisphenol A), and Phthalates (Aksglaede, Juul, Leffers, Skakkebaek, & Andersson, 2006).


Material Processing

The hormones derived from animal sources are called conjugated equine estrogens (CEEs) or are otherwise not identified (Shumaker et al., 2004). The process to extract CEEs occurs by harvesting the urine of female horses (mares). The horses are kept in closed confined quarters, are forced into continuous impregnation, and are kept hooked up to a urine collection bag that retrieves their urine for harvest. Once the mare has given birth, its foul is immediately taken and transported to feedlots, slaughterhouses, or placed in the production line for urine harvest. These Pregnant Mare Urine Farms are found in parts of the U.S.A and are increasing in places where horse slaughter is more acceptable including China, Kazakhstan, and Poland (Last Chance For Animals [LCA], n.d.). Once the equine urine has been harvested, it is then transported to laboratories and processing plants.

Although it is extremely difficult to track down the definite methods used by contraceptive brands to obtain phytoestrogens, it can be easily hypothesized that the plants used including soy, pomegranates, and oilseeds are harvested from monocultures, as this is the predominant method of crop production (Masuda & Goldsmith, 2009). There is also scarce reporting of the transportation methods the main birth control brands use to get phytoestrogens from the crops to the lab.

Xenoestrogens such as PCBs, BPAs, and Phthalates are produced in scientific and medical laboratories (Rochester & Bolden, 2015). The percentage of such xenoestrogens produced for the purpose of hormonal birth control is scarcely un-reported. However, these synthetic chemical compounds are reported as being globally mass-produced chemicals, with more than 2.2 million tons of BPA produced in 2009 alone (Kelland, 2010).

In order for scientist and medical professionals to cultivate a compound from each of these synthetic sources that will have the desired hormonal effect for human contraceptive use, requires compound extraction, transportation, and research to find the desired compound structure and function. Thus, part of the extraction process of these materials calls for research trials in which researchers, research subjects such as mice or rabbits, time, transportation methods, and laboratory materials are needed.


Product Manufacturing

Reporting of how these compounds are manufactured and made into a pill, injection, patch, or intra-uterine object for contraceptive use was extremely difficult to find. One report produced for a United States patent provided information on the manufacturing process of phytoestrogen supplements prepared from pomegranate material including pomegranate seeds (Lansky, 2000). This process included five different methods of preparation depending on if the phytoestrogen were to be used orally, topically, or otherwise. Each process entailed the pomegranate material being prepared, combined with other materials such as coconut or bee honey, chemically altered through methods of chemistry, combined with other pharmaceutical components, and placed into gel caps or containers depending on intended method use.

A website created by several professionals including scientists, mathematicians, engineers, and medical researchers called 'How Products are Made' (2018) describes the general manufacturing process of birth control pills as follows


1. Using a process known as the wet granulation method, the active ingredients—the powders containing synthetic versions of estrogen and progestin—are mixed together with a dilutant and a disintegrant (products that dilute the powders and cause them to dissolve in liquid) in a large mixer resembling the mixmaster found in many kitchens. For larger batches, a device known as a twin-shell blender may be used.

2. Solutions carrying a binding agent (the material that will cause the contents of the tablet to cohere) are stirred into the powder mass, which is wetted until it takes on the consistency of brown sugar.

3. The powder mass (known as wet granulation) is forced through a mesh screen.

4. The moist material is then placed on shallow trays covered with large sheets of paper and placed in drying cabinets.

5. A lubricant, in the form of a fine powder, is screened onto the dried material (known as dry granulation).

6. The lubricant and the dry granulation are then mixed in a blender, using a turnbling-type action.

7. Tablets are formed from the mixture, typically using a method known as direct compression. Direct compression uses steel punches and dies in large machines, which press tablets directly from the powdered mixture. The physical composition of the powdered mixture is not altered in any way. The punch and die system is often computerized.

8. The tablets are inspected to ensure compliance with federal regulations and packaged for shipment to pharmacies. Life Cycle Assessment: Hormonal Contraceptives


Distribution

You can get birth control pills at drugstores, health clinics, or Planned Parenthood health centers (Planned Parenthood, n.d.). Other forms of hormonal contraceptives such as injections or intrauterine devices are given by doctors. There are now newer ways of obtaining some birth control such as getting it delivered to your door and some schools are now even administering it to certain students (Bedside Providers, n.d.; The Atlantic, 2015).


Usage

Hallie Sklar (n.d.), a writer for Parents.com list and describes the nine most common forms of birth control methods as follows


The combined pill- a daily prescription pill that contains estrogen and progestin

The “mini pill” – a daily prescription pill containing progestin only

The Depo-Provera shot- an injection every three months containing progestin

The patch- A thin, beige plastic patch you place on your butt, tummy, or arm once a week for three weeks [reelasing synthetic progestin and estrogen]

Diaphragms, caps, and shields- soft latex or silicone barriers that cover the cervix [non-hormonal]

NuvaRing- a prescription ring inserted into the vagina once a month that releases synthetic estrogen and progestin

Condoms- A sheath of thin latex or plastic worn on the penis that collects semen [non-hormonal]

IUDs (ParaGard, Mirena) – A T-shaped plastic devise inserted into the uterus releasing progestin, or a non-hormonal T-shaped copper devise inserted into the uterus Life Cycle Assessment: Hormonal Contraceptives

The Implant- a matchstick- size implant inserted under the skin of the upper arm releasing progestin


Among these most common options: eight out of nine can only be used by females and seven out of eight works by releasing hormones into the female body. In general, hormonal contraceptive options critically outweigh non-hormonal options, 15.9% of women (in America alone) aged 15-44 currently use the hormonal pill, and approximately 18% of the world’s contraceptive users choose a hormonal one. More and more women choose to utilize one or more of the contraceptive methods now available for any number of reasons including birth control, menstruation regulation, acne regulation, and prevention of sexually transmitted diseases.

The use of hormonal contraceptives has also influenced the course of history, not only of women but the entire world. Since its introduction into society, more women have been able to efficiently plan when and how to start a family, enter and remain in the workforce, receive education and pursue higher education, and participate more fully in the world’s social, political and economic systems.


End of life

The synthetic progestin and estrogen hormones are processed on the individual level by the human endocrine system which then gets disposed of through the public wastewater systems. Harrison, Holmes, and Humfrey (1997) describe how scientific evidence has led to the realization that these synthetic hormones impact human biology as well as many other life forms in the environment. “In humans, there is strong evidence for such trends in the incidences of testicular and female breast cancer, and concern has also been expressed regarding semen quality, cryptorchidism, hypospadias, and polycystic ovaries. … [C]oncern [also] exists and is strengthened by reports of adverse reproductive and developmental effects in wildlife… among