Updated: Apr 15
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).
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).
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.
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
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).
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
mammals, disturbed fertility of Florida panthers and some marine species have also been reported” (Harrison et. al, 1997). It is reported that wild populations of fish, alligators and birds, instances of masculinization or feminization in polluted areas have been noted (Harrison et. all, 1997).
It is clear from the life cycle assessment conducted that much more extensive research needs to be done on the individual, social, and environmental impacts of synthetic hormones used for contraceptives. In order to do this, it is suggested that direct and clear descriptions of the exact methods used in the resourcing, production, and manufacturing of these hormonal birth control contraceptives by each pharmaceutical brand and company producing them, be made available to the public. The positive impact of contraceptive use for female mobility, autonomy, and success in our society is clear. However, because the need and desire of women to use contraceptives are so great, it is imperative that safe methods are utilized in order to keep the individual, social, and environmental impacts positive rather than lethal. Life Cycle Assessment: Hormonal Contraceptives
Written by: Morgan Hopson, 2018
Aksglaede, L., Juul, A., Leffers, H., Skakkebæk, N. E., & Andersson, A. M. (2006). The sensitivity of the child to sex steroids: possible impact of exogenous estrogens. Human reproduction update, 12(4), 341-349.
Bedsider. (n.d.). Birth control methods: Where to get it. Retrieved from https://www.bedsider.org/where_to_get_it
Center for Disease Control and Prevention. (2016). National center for health statistics- contraceptive use. Retrieved from https://www.cdc.gov/nchs/fastats/contraceptive.htm
Harding, S. (2017). Birth cotrol pill ingredients. Retrieved from https://www.livestrong.com/article/26463-birth-control-pill-ingredients/
Harrison, P. T. C., Holmes, P., & Humfrey, C. D. N. (1997). Reproductive health in humans and wildlife: are adverse trends associated with environmental chemical exposure?. Science of the Total Environment, 205(2-3), 97-106.
Kuhl, H. (2005). Pharmacology of estrogens and progestogens: influence of different routes of administration. Climacteric, 8(sup1), 3-63.
Lansky, E. P. (2000). U.S. Patent No. 6,060,063. Washington, DC: U.S. Patent and Trademark Office.
Last Chance for Animals. (n.d.). Horses-premarin. Retrieved from http://lcanimal.org/index.php/campaigns/other-issues/horses
Masuda, T., & Goldsmith, P. D. (2009). World soybean production: area harvested, yield, and long-term projections. International food and agribusiness management review, 12(4), 143-162. Life Cycle Assessment: Hormonal Contraceptives
Planned Parenthood. (n.d.). How do I get birth control pills? Retrieved from https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/how-do-i- get-birth-control-pills
Pradhan, D. K., Mishra, M. R., Mishra, A., Panda, A. K., Behera, R. K., Jha, S., & Choudhury, S. (2013). A comprehensive review of plants used as contraceptives. International Journal of Pharmaceutical Sciences and Research, 4(1), 148.
Rochester JR, Bolden AL. 2015. Bisphenol S and F: a systematic review and comparison of the hormonal activity of bisphenol A substitutes. Environ Health Perspect 123:643– 650; http://dx.doi.org/10.1289/ehp.1408989
Rossberg, Manfred; Lendle, Wilhelm; Pfleiderer, Gerhard; Tögel, Adolf; Dreher, Eberhard- Ludwig; Langer, Ernst; Rassaerts, Heinz; Kleinschmidt, Peter; Strack (2005), "Chlorinated Hydrocarbons", Ullmann's Encyclopedia of Industrial Chemistry, Weinheim: Wiley-VCH, doi:10.1002/14356007.a06_233.pub2
Shumaker, S. A., Legault, C., Kuller, L., Rapp, S. R., Thal, L., Lane, D. S., ... & Masaki, K. (2004). Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative Memory Study. Jama, 291(24), 2947-2958.
Sklar, H. (n.d.). 9 common birth control options. Retrieved from https://www.parents.com/parenting/relationships/postpartum-birth-control/common- birth-control-options/
Urist, J. (2015). Schools, birth control, and parental consent: A debate over whether school-based health centers should be able to offer IUDs. Retrieved Life Cycle Assessment: Hormonal Contraceptives from https://www.theatlantic.com/education/archive/2015/09/student-health-centers- schools-contraception/403954/