RGS Articles

Sunday, July 16, 2006

Sex, Bishops, and Garci Tapes

By Carolina S. Ruiz Austria, Senior Lecturer, UP College of Law

On matters sexual, a dirty mind is deadlier than a well-informed one.

Ignorance about sex may be the Catholic Bishops' preferred strategy
for protecting Catholic teen-agers but both history and evidence-based
research has consistently shown us that such a strategy has never
worked to actually protect young people.

The World Health Organization (WHO) recently published a review of
1,050 scientific articles on sex education programs. Researchers found
"no support for the contention that sex education encourages sexual
experimentation or increased activity. If any effect is observed,
almost without exception, it is in the direction of postponed
initiation of sexual intercourse and/or effective use of
contraception." Failure to provide appropriate and timely information
"misses the opportunity of reducing the unwanted outcomes of
unintended pregnancy and transmission of STDs, and is, therefore, in
the disservice of our youth," according to the report.(Grunseit A,
Kippax S. Effects of Sex Education on Young People's Sexual Behavior.
Report commissioned by the Youth and General Public Unit, Office of
Intervention and Development and Support, Global Program on AIDS, WHO.
North Ryde: National Centre for HIV Social Research, Macquarie
University)

In a 1997 UNAIDS impact study, 14 of the 15 studies did not indicate
that sexual health education leads to earlier initiation or greater
sexual activity.

Likewise, the same study cites that all five of the comparison studies
across international or national contexts indicated that when and
where there was open and liberal policy as well as the provision of
sexual health education and related services (e.g. family planning)
there were lower pregnancy, birth, abortion, and STD rates.(Impact of
HIV and sexual health education on sexual behavior of young people: a
review update, United Nations program on HIV/AIDS-1997. Update by Anne
Grunseit of the review by Grunseit & Kippax, WHO/GPA, Geneva, 1993.)

Respecting Difference

Yet even if we were to respect religious difference and grant that the
Catholic Bishops have every right to totally shun (whether feigned or
otherwise) all forms and manner of sexuality and sexual expression,
what gives them the right to dictate their religious views above all
others in state policy?

In a recent case, the Supreme Court interestingly took what could be
considered a courageous step towards protecting the true goal of the
Constitutional clauses on religious freedom: that is respecting
difference, and protecting the rights of "religious minorities."


A court employee who faced administrative charges of "immorality" for
living-in with a man (for over 20 years, that is longer than most
marriages, civil or otherwise) when both of them had previous
subsisting marriages raised the issue of religious freedom. It turned
out that as far as the Jehova's Witness was concerned, the couple
fulfilled the requirements of the religion for a valid marriage and
thus were considered married in the eyes of the same religion.

In 2003, the Court remanded the case back to the Deputy Court
Administrator but on June 22, 2006 , the court decided to uphold
Soledad Escritor's defense and finally dismissed the administrative
complaint against her.

In this case, the court had occasion to consider the secular character
of "public morality," noting that the clauses on religion in the
Constitution "prohibit the state from establishing a religion
including the morality it sanctions."[Estrada vs Escritor, AM No.
P-02-1651, 22 June 2006]

Moving Morality out of the Box
Unfortunately, all its posturing on morality has tended to always
focus on its version of "sexual morality," standards of abstinence
and celibacy which even its own priests have often violated.

How else can a group of Bishops hold so much power and influence over
state policy if it didn't have this unity with no less than the
President herself who has often spoken against reproductive health
policy?

This is why despite the unfolding controversy over purported
differences between the CBCP and Malacanang over mining law and the
scandal over monetary bribes, what still stands out is the complicity
between GMA and the CBCP in railroading all manner of reproductive
health programs and policy.

Between its opposition to giving young people information along with
helping them acquire life skills in making safe, healthful and most
certainly moral choices in life, and its indecision on the issue of
rigging an election and using public funds to orchestrate it all, the
CBCP is clearly experiencing no less than a crisis of morality.
(Excerpt from upcoming article "The Dangerous tendency of a Dirty
Mind:
Sex and the Catholic Bishops," on "Heresy, " at
www.carolinaruizaustria.blogspot.com

Wednesday, July 12, 2006

Safer and more advanced contraceptives hit the market

Date: Monday, July 10, 2006
Source: Los Angeles Times (US)
Author: Shari Roan

Now, a birth control bonanza; As safer and more advanced contraceptives hit the market, women can tailor their methods to fit their lifestyles.

This is turning out to be a pivotal year in birth control.

In the last six months, the Food and Drug Administration has approved an oral contraceptive that eliminates a monthly menstrual period, and can prevent mood swings and other side effects. It also has approved two others that feature shorter periods. And soon it's expected to sign off on a yearlong oral contraceptive and a simpler version of a contraceptive implant.

Of course, there's no long-term data on the new methods -- and they aren't for everyone -- but doctors consider this new generation of birth control to be less risky and more sophisticated than the decades-old predecessors. And still in development are even safer, more advanced options -- with natural hormones and smoother delivery methods.

"Anytime there is a new method, there will be some women who say, 'Oh, thank goodness, there is something for me,' " says Dr. Carolyn L. Westhoff, medical director of the family planning clinics at N! ew York Presbyterian/Columbia University Medical Center in New York. "It's not that different than trying to find the best pair of jeans to fit your body."

That's not an easy thing to do. But what seems to fit many women is curtailing or eliminating menstruation altogether.

Two brands of birth control pills, both approved earlier this year and now available, feature shorter periods than the usual five to seven days. The products -- Loestrin 24 Fe and Yaz -- provide 24 days of active pills, forms of the hormones estrogen and progestin, followed by four days of placebo pills.

And in May, the FDA approved Seasonique, a slightly different version of Seasonale, which was approved in 2003 as the first continuous-use oral contraceptive. With Seasonale, which will become available in September, women take the active pills for 84 days followed by seven days of inactive pills to allow for a period. Seasonique, however, substitutes low-dose estrogen in place of the placeb! o pills so that a woman's hormone levels don't crash during the off we ek.

Finally, the FDA is considering an application to approve the first year-long oral contraceptive. Lybrel contains only active pills without any break for a period. "For the last 40 years of the pill, one thing we've done is we've lowered the dose for improved safety," Westhoff says. "But all along we were sticking to this original recipe of 21 days of hormones and seven days of placebo."

The shift to continuous-use oral contraceptives acknowledges a little known fact: Women don't need to have periods.

Although early pills were associated with high levels of hormones and a related risk of blood clots, the level of hormones in birth control pills has dropped dramatically in the last two decades. Now, even taking an active pill 365 days a year is not thought to be harmful, says Dr. David Portman, director of the Columbus Center for Women's Health Research in Columbus, Ohio.

Nor does the extended-use regimen appear to interfere with fertility. In a study of 1! 87 women presented in May at a meeting of the American College of Obstetricians and Gynecologists, researchers reported that almost 99% of the women had a period or became pregnant within 90 days of stopping the medication.

"There is no lingering effect of the medication in the body because it is metabolized very quickly," says Dr. Anne R. Davis, an assistant professor at Columbia University and lead investigator of the study. When oral contraceptives were first introduced decades ago, the placebo week "was put in there to mimic the natural cycle," she says. "It was done with the idea that the pill would be more acceptable to women. It wasn't done because of safety or effectiveness."

That's not to say the pills are right for everyone. For those with a shaky memory, the downside of a year-round pill is remembering it every day. In addition, women who miss pills may have more trouble determining if they are pregnant without a break from the pill for menstruation.

! "You would have to go on other symptoms to know if you're pregnant," D avis says. Oral contraceptive use during early pregnancy is not thought to be linked to birth defects, she says.

However, the effects of taking Lybrel during several months of pregnancy have not been specifically studied. And some health experts caution that there is a lack of data on continuous-use birth control pill regimens.

*

Long-term protection

For women who find daily methods difficult, the first contraceptive implant to emerge since Norplant was removed from the market in 2002 is expected to be approved by the FDA later this year.

That earlier implant consisted of six matchstick-size rods that were placed under the skin of the forearm to release fertility-controlling hormones. But the product was plagued with problems, including the difficulty of inserting and removing the rods.

The new implant, Implanon, consists of a single rod that can prevent pregnancy for three years and is now under FDA review.

Other long-term contraceptives approved! in recent years include NuvaRing, which became available in 2001. A small, flexible vaginal ring that releases hormones, it's worn for three weeks then removed for one week. And Mirena, a hormone-releasing intrauterine device, was approved in 2001 and provides five years of protection.

Another long-term contraceptive, the injectable Depo-Provera, was reformulated in 2004 with lower doses of hormones. The newer formulation is injected four times a year under the skin instead of into the muscle, Westhoff says. A weekly method has also found a niche. Ortho Evra, the first transdermal contraceptive patch, was approved in 2001. Each hormone-releasing patch is worn for one week; after three weeks, no patch is worn to allow for a menstrual cycle.

Some of the newer products do carry some specific risks. In November, the FDA changed the labeling for the Ortho Evra patch to warn that the product exposes women to higher levels of estrogen than most birth control pills, which ! may increase the risk of blood clots. And Depo-Provera has been found to reduce bone density, although the newer formulation is thought to cause less bone loss.

*

Enhancing methods

Simply having more options isn't enough for scientists, doctors -- or patients.

Researchers are working to refine existing contraceptives and create new ones. Although hormonal methods are now considered extremely safe, they do carry some risks. Women with a history of blood clots, heart attack, stroke, liver disease or cancer of the breast or sex organs are generally not advised to use hormonal contraceptives.

So as scientists continue to study how to reduce the risks of birth control, they're exploring the use of the natural hormone estradiol to replace ethinyl estradiol, the synthetic version of estradiol found in the majority of hormonal contraceptives that can increase the risk of blood clots and cardiovascular events in susceptible women.

The Population Council, a nonprofit organization that conducts health research, is studying a hormo! nal contraceptive that uses natural estradiol combined with nesterone, a synthetic progestin that closely resembles the natural hormone progesterone. Although nesterone can't be absorbed orally, the combination could be used in a spray or gel applied to the skin.

"The combination will be much more natural than all of these synthetic combinations that are available at the moment," says Regine Sitruk-Ware, executive director of research and development. "We could expect to avoid the metabolic and cardiovascular side effects."

<< Los Angeles Times -- 7/10/06 >>

Safer and more advanced contraceptives hit the market

Date: Monday, July 10, 2006
Source: Los Angeles Times (US)
Author: Shari Roan

Now, a birth control bonanza; As safer and more advanced contraceptives hit the market, women can tailor their methods to fit their lifestyles.

This is turning out to be a pivotal year in birth control.

In the last six months, the Food and Drug Administration has approved an oral contraceptive that eliminates a monthly menstrual period, and can prevent mood swings and other side effects. It also has approved two others that feature shorter periods. And soon it's expected to sign off on a yearlong oral contraceptive and a simpler version of a contraceptive implant.

Of course, there's no long-term data on the new methods -- and they aren't for everyone -- but doctors consider this new generation of birth control to be less risky and more sophisticated than the decades-old predecessors. And still in development are even safer, more advanced options -- with natural hormones and smoother delivery methods.

"Anytime there is a new method, there will be some women who say, 'Oh, thank goodness, there is something for me,' " says Dr. Carolyn L. Westhoff, medical director of the family planning clinics at N! ew York Presbyterian/Columbia University Medical Center in New York. "It's not that different than trying to find the best pair of jeans to fit your body."

That's not an easy thing to do. But what seems to fit many women is curtailing or eliminating menstruation altogether.

Two brands of birth control pills, both approved earlier this year and now available, feature shorter periods than the usual five to seven days. The products -- Loestrin 24 Fe and Yaz -- provide 24 days of active pills, forms of the hormones estrogen and progestin, followed by four days of placebo pills.

And in May, the FDA approved Seasonique, a slightly different version of Seasonale, which was approved in 2003 as the first continuous-use oral contraceptive. With Seasonale, which will become available in September, women take the active pills for 84 days followed by seven days of inactive pills to allow for a period. Seasonique, however, substitutes low-dose estrogen in place of the placeb! o pills so that a woman's hormone levels don't crash during the off we ek.

Finally, the FDA is considering an application to approve the first year-long oral contraceptive. Lybrel contains only active pills without any break for a period. "For the last 40 years of the pill, one thing we've done is we've lowered the dose for improved safety," Westhoff says. "But all along we were sticking to this original recipe of 21 days of hormones and seven days of placebo."

The shift to continuous-use oral contraceptives acknowledges a little known fact: Women don't need to have periods.

Although early pills were associated with high levels of hormones and a related risk of blood clots, the level of hormones in birth control pills has dropped dramatically in the last two decades. Now, even taking an active pill 365 days a year is not thought to be harmful, says Dr. David Portman, director of the Columbus Center for Women's Health Research in Columbus, Ohio.

Nor does the extended-use regimen appear to interfere with fertility. In a study of 1! 87 women presented in May at a meeting of the American College of Obstetricians and Gynecologists, researchers reported that almost 99% of the women had a period or became pregnant within 90 days of stopping the medication.

"There is no lingering effect of the medication in the body because it is metabolized very quickly," says Dr. Anne R. Davis, an assistant professor at Columbia University and lead investigator of the study. When oral contraceptives were first introduced decades ago, the placebo week "was put in there to mimic the natural cycle," she says. "It was done with the idea that the pill would be more acceptable to women. It wasn't done because of safety or effectiveness."

That's not to say the pills are right for everyone. For those with a shaky memory, the downside of a year-round pill is remembering it every day. In addition, women who miss pills may have more trouble determining if they are pregnant without a break from the pill for menstruation.

! "You would have to go on other symptoms to know if you're pregnant," D avis says. Oral contraceptive use during early pregnancy is not thought to be linked to birth defects, she says.

However, the effects of taking Lybrel during several months of pregnancy have not been specifically studied. And some health experts caution that there is a lack of data on continuous-use birth control pill regimens.

*

Long-term protection

For women who find daily methods difficult, the first contraceptive implant to emerge since Norplant was removed from the market in 2002 is expected to be approved by the FDA later this year.

That earlier implant consisted of six matchstick-size rods that were placed under the skin of the forearm to release fertility-controlling hormones. But the product was plagued with problems, including the difficulty of inserting and removing the rods.

The new implant, Implanon, consists of a single rod that can prevent pregnancy for three years and is now under FDA review.

Other long-term contraceptives approved! in recent years include NuvaRing, which became available in 2001. A small, flexible vaginal ring that releases hormones, it's worn for three weeks then removed for one week. And Mirena, a hormone-releasing intrauterine device, was approved in 2001 and provides five years of protection.

Another long-term contraceptive, the injectable Depo-Provera, was reformulated in 2004 with lower doses of hormones. The newer formulation is injected four times a year under the skin instead of into the muscle, Westhoff says. A weekly method has also found a niche. Ortho Evra, the first transdermal contraceptive patch, was approved in 2001. Each hormone-releasing patch is worn for one week; after three weeks, no patch is worn to allow for a menstrual cycle.

Some of the newer products do carry some specific risks. In November, the FDA changed the labeling for the Ortho Evra patch to warn that the product exposes women to higher levels of estrogen than most birth control pills, which ! may increase the risk of blood clots. And Depo-Provera has been found to reduce bone density, although the newer formulation is thought to cause less bone loss.

*

Enhancing methods

Simply having more options isn't enough for scientists, doctors -- or patients.

Researchers are working to refine existing contraceptives and create new ones. Although hormonal methods are now considered extremely safe, they do carry some risks. Women with a history of blood clots, heart attack, stroke, liver disease or cancer of the breast or sex organs are generally not advised to use hormonal contraceptives.

So as scientists continue to study how to reduce the risks of birth control, they're exploring the use of the natural hormone estradiol to replace ethinyl estradiol, the synthetic version of estradiol found in the majority of hormonal contraceptives that can increase the risk of blood clots and cardiovascular events in susceptible women.

The Population Council, a nonprofit organization that conducts health research, is studying a hormo! nal contraceptive that uses natural estradiol combined with nesterone, a synthetic progestin that closely resembles the natural hormone progesterone. Although nesterone can't be absorbed orally, the combination could be used in a spray or gel applied to the skin.

"The combination will be much more natural than all of these synthetic combinations that are available at the moment," says Regine Sitruk-Ware, executive director of research and development. "We could expect to avoid the metabolic and cardiovascular side effects."

<< Los Angeles Times -- 7/10/06 >>