Talk:Combined oral contraceptive pill

Unnacurate sentences

On Placebo: "The presence of placebo pills is thought to be comforting, as menstruation is a physical confirmation of not being pregnant"

This sentence is confusing, as it induces the reader to expect an explanation to the use of placebo pills further to the reinforcement of the daily habbit, such as an anxiety relief effect.

It seems the statement refers not to the placebo pills but to the allowance of a monthly menstruation, which needs not "the presence of placebo pills" but only the cease to take active pills.

This could be rewritten as "The no-pill or placebo pill week" or "The 7 day cease of active pills" or any sintagm of similar meaning, followed by "is thought to be conforting...". Unless the original statement was due to have some other meaning I have not understood in which case I suggest it is more accurately explained.

On sexuality: "Many women taking the pill enjoy sex more because of reduced anxiety over pregnancy" This cannot be stated as a positive effect on sexuality caused by the pill, since it is exclusively psichologycal and is common to every contraceptive method with a low failure risk. I suggest it is removed or complemented with "as with any other contraceptive method", being the first preferrable since this information seems extremely obvious, common sensed and hence unnecessary.

--85.62.98.226 (talk) 12:04, 24 September 2008 (UTC)

Percy Julian again

71.182.107.102:

• 01:02, 23 October 2008 (→External links)

and
70.16.52.193:

• 12:53, 26 October 2008 (→External links)
• 12:56, 26 October 2008 (→External links)
• 12:59, 26 October 2008 (→External links)
• 12:59, 26 October 2008 (→External links)

have repeatedly added a June 24, 2007 personal blog post by Usha Alexander (http://blog.shunya.net/shunyas_blog/2007/06/percy-julian-ch.html) to the external links section of this article.

This is an inappropriate external link. Please see WP:LINKSTOAVOID:

Except for a link to an official page of the article subject—and not prohibited by restrictions on linking—one should avoid:
11. Links to blogs and personal web pages
13. Sites that are only indirectly related to the article's subject

This has prompted Zodon to repeatedly substitute an inappropriate "See also" section with a link to the Percy Lavon Julian article:

• 02:20, 23 October 2008 (Remove external link to Bio of Percy Julian, replace with see also to Percy Lavon Julian)
• 06:13, 26 October 2008 (Undid revision 247645307 by Lynn4 (talk) Percy Julian synthesized progesterone, etc. from plant sterols, preceding mexican yams, etc.)

A "See also" section for a link to the Percy Julian article is inappropriate—because Percy Julian did not play a role in the history of the Pill.
Please see:

• Talk:Percy Lavon Julian#GA Sweep Review
• Talk:Combined oral contraceptive pill/Archive 1#Percy Julian

Russell Marker

• Marker invented the chemistry (the Marker degradation) in 1938 to synthesize progesterone and other steroids from sapogenins, including diosgenin from Dioscorea
• Marker discovered in 1942 that the inedible Mexican wild yams cabeza de negro (Dioscorea mexicana) and the more remote barbasco (Dioscorea composita) were exceptionally rich sources of diosgenin and excellent raw materials from which to synthesize progesterone and other steroids
• Marker synthesized 3 kg of progesterone from cabeza de negro in 1943, founded Syntex in 1944, founded Botanica-Mex (which became Hormonosynth then Diosynth) in 1945, and thereby founded the Mexican steroid industry
• Syntex, using the Marker degradation and the raw material (Mexican barbasco) discovered by Marker, reduced the bulk price of progesterone almost 200-fold over 8 years -- from $80/g in 1943 to $0.48/g in 1951
• Syntex supplied the progesterone used by Pincus and Chang when they began their contraceptive research in 1951 by repeating the 1937 experiments in rabbits of Makepeace et al.
• Syntex supplied the progesterone used by Pincus and Rock in their clinical trials of progesterone in 1953
• Djerassi et al. at Syntex in 1951 synthesized (from steroids using the Marker degradation and the raw material (Mexican barbasco) discovered by Marker) the first (norethisterone) of the three progestins used in Pincus and Rock's clinical trials of progestins beginning in 1954
• Almost all of the oral contraceptives manufactured in the 1960s were produced from Mexican steroids using the Marker degradation and the raw material (Mexican barbasco) discovered by Marker
• Most of the oral contraceptives manufactured in the 1960s were produced either by Syntex for Syntex or produced by Syntex for Ortho and Janssen (norethisterone) or under license from Schering for Schering and Parke-Davis (norethisterone acetate)

Percy Julian

• Julian did not play a role in the history of the development of the Pill
• The Glidden Company did not play a role in the history of the development of the Pill
• Julian Laboratories, Inc. did not play a role in the history of the development of the Pill
• Smith Kline and French did not play a role in the history of the development of the Pill (and never developed any contraceptives)

I also removed an inappropriate external link added on July 22, 2008 by 12.106.237.2:

• 13:57, 22 July 2008 (→External links) Long-Term Birth Control Pill Use Linked to Possible Heart Risks
  

an anonymously authored article on a personal commercial website (http://www.myproductalert.com) with an objectionable amount of advertising.

This is an inappropriate external link. Please see WP:LINKSTOAVOID:

Except for a link to an official page of the article subject—and not prohibited by restrictions on linking—one should avoid:
4. Links mainly intended to promote a website
5. Links to sites that primarily exist to sell products or services, or to sites with objectionable amounts of advertising.

Lynn4 (talk) 15:56, 26 October 2008 (UTC)

See also Percy Julian

I agree that the external link regarding Percy Julian was inappropriate to this article. However the Wikipedia article on Percy Julian indicates in several places that he played a role in birth control pills, and therefore a see also link seems reasonable.

"His work would lay the foundation for the steroid drug industry's production of cortisone, other corticosteroids, and birth control pills. He later started his own company to synthesize steroid intermediates from the Mexican wild yam. His work helped reduce the cost of steroid intermediates to large multinational pharmaceutical companies."

"The result was the female hormone progesterone which was put on the American market in bulk for the first time."

He was also apparently involvement in breaking a monopoly on Mexican yams used in progesterone production.

He seems to have had significant roles in several companies producing progesterone etc. from various plant sources - e.g. soy beans, yams. Inovating, helping to reduce prices, etc.

The development of something (i.e. creating the first one) is not the only part of a products history. Manufacturing, product refinements, improvements in manufacturing processes, cost reductions, dealing with regulatory barriers, precursors, attempts that didn't work out are also part of history.

If the article on Percy Julian is incorrect, then it should of course be corrected. But as it stands, based on the contents of the Wikipedia article on Julian, a see also seems reasonable. If one is interested in the history of steroid chemistry, history of progesterone production, etc., he seems to have played a significant part. (At the moment there is a lot more history material on his page than on several of the other pages, such as Syntex.)

Is there a more appropriate intermediary article (e.g. on history of steroid chemistry, etc.) that would get one to information about this and be a more appropriate see also? Zodon (talk) 00:34, 27 October 2008 (UTC)

The Percy Julian Wikipedia article claims (inaccurately) in only one place that Julian played a role in the development of birth control pills:

In the February 6, 2007 NOVA television dramatization of Percy Julian's life, "Forgotten Genius", the narrator at one point says:

"The work of Julian and Marker would lay the foundation for a whole new class of medicines, including the birth control pill and a wonder drug that would soon take the world by storm."

This is the source for the third sentence of the Percy Julian Wikipedia article:

"His work would lay the foundation for the steroid drug industry's production of cortisone, other corticosteroids, and birth control pills."

This sentence is inaccurate with respect to birth control pills, but WP:V says: "The threshold for inclusion in Wikipedia is verifiability, not truth," so it is not worth fighting for the removal of this inaccurate sentence from the Percy Julian Wikipedia article about Percy Julian that is based on a television dramatization of Percy Julian's life.

But this is the Combined oral contraceptive pill Wikipedia article about the Pill, which is based on many authoritative books and journal articles about the Pill.

• WP:REDFLAG says "Exceptional claims in Wikipedia require high-quality sources; if such sources are not available, the material should not be included."
• WP:RS says: "Reliable sources are credible published materials with a reliable publication process; their authors are generally regarded as trustworthy or authoritative in relation to the subject at hand. How reliable a source is depends on context."

In this article about the Pill, making the claim that Percy Julian played a role in the history of the Pill—when no book or journal article about the Pill even mentions Percy Julian (because Percy Julian did not play a role in the history of the Pill)—is an exceptional claim that requires high-quality sources.

• One sentence by a narrator in a television dramatization of Percy Julian's life is not a "high-quality source" that can justify the inclusion of an exceptional (and inaccurate) claim.
  
• The authors of a television dramatization of Percy Julian's life are not "generally regarded as trustworthy or authoritative in relation to the subject at hand"—the history of the development of the Pill.
  

The inaccurate and misleading Percy Julian Wikipedia article is not a WP:RS for this Wikipedia article.

• WP:SPS says: "Articles and posts on Wikipedia, or other websites that mirror Wikipedia content, may not be used as sources."

A "See also" section in this article to provide a link to the Percy Julian article is absolutely inappropriate.

Lynn4 (talk) 05:30, 27 October 2008 (UTC)

What affects Birth Control?

What medications/supplements can cause the birth control pill to be ineffective? 69.248.200.210 (talk) 01:58, 30 November 2008 (UTC)

Anti-tuberculosis meds - Rifampicin and rifabutin

Systemic antifungal - Griseofulvin, theoretically might reduce OC efficacy.

Anticonvulsants - barbituates, carbamazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, topiramate and felbamate

Anti-HIV protease inhibitors

Saint John’s Wort - not well studied, but some expertes some experts recommend increasing dose of EC by 50% in women using it.

[Source for all of the above - Contraceptive tech, 18th ed, page 436-7]

Others:

Tretinoids - Accutane, Soriatane

Ginseng, or black cohosh may also. Zodon (talk) 02:53, 30 November 2008 (UTC)

Grapefruit and juice? —Preceding unsigned comment added by 118.90.57.238 (talk) 00:56, 11 January 2009 (UTC)

Dubious sentence

I found this in the subsection "Placebo Pills"

"The withdrawal bleeding that occurs during the break from active pills is thought to be comforting, as a physical confirmation of not being pregnant." This is rather POV and it seems, well, dubious. Can someone back this up with a survey result or something? When was it established that the bleeding is generally "comforting"? I feel like this is just one person's opinion and perhaps needs removal if it can't be established as fact. --Pstanton (talk) 22:18, 4 February 2009 (UTC)

It doesn't say that bleeding in general is comforting, but that the confirmation that one is not pregnant may be comforting. Quick Google search finds a lot of places that say similar (not all copies of this article) - haven't found one I like as an RS yet. One might also look at some of the references in the article on extended cycle use (another place such issues likely to be discussed). Zodon (talk) 01:46, 5 February 2009 (UTC)

Added a citation that supports the sentence (with the change of saying was).

The following items from Contraceptive Technology, 19th ed, pages 228-229. Also seem apropos.

• The 27/7 cycle provides a "predictable, coordinated withdrawal bleed that women will interpret to be a normal (although lighter) menses. The pill's inventors touted this feature as a distinct benefit for women, which it was at the time."
• "Unless the patient wants to use bleeding as a reassurance that she is not pregnant, monthly cycling is not necessary"

So seems probable that at least one of the persons who were of that opinion was John Rock, one of the co-developers of the pill.

Article still could use improvement in coverage of cycle length, but does that provide enough to remove the dubious tag? Thanks for bringing this up (it was fun reading up on this). Zodon (talk) 06:58, 5 February 2009 (UTC)

Yes, it does. I'm removing the dubious tag. The reason for the week of placebo pills being "mental comfort" on the part of early users is well-attested.... Elatb (talk) 20:25, 4 September 2009 (UTC)

Carl Djerassi, Der Standard, The Guardian, and CathNews.com

CathNews.com and Catholic News Agency.com are not WP:Reliable sources:

1. Djerassi, Carl (December 13, 2008). Warum wir bald sehr alt ausschauen. Der Standard, Album A 3.
2. Connolly, Kate; Hooper, John (January 7, 2009). Church grabs chance to attack birth control pill. The Guardian, p. 23, reprinted January 8, 2009 on p. 6 of the Taipei Times.
3. . (January 8, 2009). Pill inventor slams ... pill. CathNews.com
4. . (January 11, 2009). Birth control pill inventor laments demographic 'catastrophe'. Catholic News Agency.com
5. . (January 24, 2009). Corrections and clarifications. The Guardian, p. 34.
6. Butterworth, Siobhain (January 26, 2009). Open door: The readers' editor on ... pills, spills and the wrong kind of splash. The Guardian p. 33.
7. Djerassi, Carl (January 27, 2009). Response: I never blamed the pill for the fall in family size. The Guardian, p. 33.

75.57.127.117 (talk) 15:54, 3 March 2009 (UTC) 75.57.127.117 (talk) 16:22, 3 March 2009 (UTC)

Thanks for the references 75.57.127.117

In response to Geremia's questions in edit summary about poorly sourced and undue weight. The above covers the former question (the edit in question just cited a brief item in CathNews).

Undue weight because recent reductions in fertility rate are driven by many factors - public health improvements, the reduction of childhood mortality, scarcity of resources, economic pressures, etc. Also, the pill is only one of the major techniques used to achieve lower fertility rates, and it does not account for the desire to do so. So while coverage of trends in fertility and role of the pill not unreasonable, coverage would need more balance in terms of what happened, why, and the roles of various contraceptives. Zodon (talk) 18:57, 3 March 2009 (UTC)

Duplicate sections

The new "health benefits" section largely duplicates the information in the "noncontraceptive uses" section. I'd suggest that these two sections be merged. Lyrl^Talk _C 13:23, 7 March 2009 (UTC)

Agree. Zodon (talk) 21:28, 7 March 2009 (UTC)

Price?

It would be nice to give an approximate price of a month's worth of the COCP, e.g in dollars or in euros.--Roentgenium111 (talk) 21:51, 12 March 2009 (UTC)

See Birth control pill - planned parenthood But it varies quite a bit by location - e.g. in the United States, medications are much more expensive than in many other countries.

Also there are the cost of side effects (estimated at $14/year for COC) and the cost of contraceptive failures (medical costs estimated at about $130/year). [By comparison, Copper-T IUD, failure costs $8/year, side effect costs $0/year; or No method $0 method cost, 0 side effect cost, failure cost $950/year (or $1900/year if assume don't want any more children)]

Estimates from James Trussell, Anjana Lalla, Quan Doan, Eileen Reyes, Lionel Pinto, Joseph Gricar (2009). "Cost effectiveness of contraceptives in the United States". Contraception 79 (1): 5-14. PMID 19041435.  [Failure costs include just the medical cost of ectopic pregnancy, spontaneous abortion, induced abortion and birth, in proportions typical to the United States. Does not client costs, time, etc. Also, except for the last, failure costs assume that 60% of births are misstimed by 2 years, rather than being unwanted. Costs in 2007 US$.]

The comparison by Trussell, et al. is from point of view of health insurer, and only goes through a few months after birth, it does not include cost of medical care for the child. The cost of raising a child is much higher (typically a few hundred thousand dollars), so failure costs for the user are much higher. Zodon (talk) 06:29, 13 March 2009 (UTC)

Happened across another bit in some other reading. In developing countries "Estimates of the cost (in 2001 dollars) for a woman’s first visit to obtain oral contraceptives average about $8.00: $1.00 for drugs and supplies, $0.50 for labor, $6.50 for overhead"

Source: Susheela Singh, Jacqueline E. Darroch, Michael Vlassoff, Jennifer Nadeau (2003). Adding it Up: The Benefits of Investing In Sexual and Reproductive Health Care (Report). The Alan Guttmacher Institute and UNFPA. ISBN 0-939253-62-3. http://www.guttmacher.org/pubs/covers/addingitup.html.  Page 13, which cites an UNFPA review. Zodon (talk) 08:14, 13 March 2009 (UTC)

Mechanisms of Action

In the Mechanisms of Action section there is a missing or broken citation.

The reference [62] (Crockett, Susan A.; Donna Harrison, Joe DeCook, and Camilla Hersh (April 1999). Hormone Contraceptives Controversies and Clarifications. American Association of Pro Life Obstetricians and Gynecologists. http://www.aaplog.org/decook.htm. Retrieved on 2008-02-26.) goes to a dead link. I searched for the paper on Pubmed and scholar.google and found nothing but citations of this paper, but no paper itself. I went to the publisher's page and found a pro-life advocacy group, not a medical journal. I don't believe this is a valid citation. Not only does it appear to be an un-peer-reviewed source, it is also apparently missing from the internet.

Furthermore, the citation is given in support of this statement: "Others make more complex arguments against the existence of [endometrial effects that prevent implantation of an embryo in the uterus]." I am not sure that a pro-life advocacy group would want to refute claims of endometrial effects, since they generally take the position that this is a form of chemical abortion. Therefore, even if this paper could be found, I wonder how likely it is to be a good supporting paper for the claim that there are "complex arguments against" these effects. —Preceding unsigned comment added by 0dimensional (talk • contribs) 15:48, 11 May 2009 (UTC)

I have updated the link. Note that another place to look for text of links that have gone dead is through the Internet Archive (http://www.internetarchive.org). This paper is available at the old address through the Archive: http://web.archive.org/web/20080203114728/http://www.aaplog.org/decook.htm

A pro-life advocacy group composed exclusively of MDs specializing in obstetrics and gynecology carries more credibility than the average pro-life group. The members of AAPLOG disagree on whether or not combined hormonal contraceptives are abortifacient, and the group has published position papers arguing both sides. They explain themselves some more here. Lyrl^Talk _C 21:54, 13 May 2009 (UTC)

Side Effects

The Side effects part of this article seems to be slightly out of date? thathere have been new studies which have found other side effects like the link between use of the pill and sexual disfunction which have been published:'The study, conducted by American endocrinologist, Claudia Panzer, included 124 premenopausal women who had experienced long-term sexual dysfunction. The women were divided into three groups: continued birth control pill users, former pill users, and women who had never used the pill before. SHBG levels for all three groups were taken on three separate occasions: at the commencement of the study, 80 days after pill discontinuation, and 120 after pill discontinuation etc'seperate similar studies have shown that these side effects maintain also after the discontinuation of the pill. incidentally there was an articlke in metro about how woman on the pill seemed to prefer the smell of men who were genetically more similar over the scent of man who are genetically more dissimilar to themselves (87.192.128.174 (talk) 18:33, 5 July 2009 (UTC)) Regarding the first part of the topic ,apologies for the typo's i have some urls support this observation below.

• http://www.medicalnewstoday.com/articles/35663.php
• http://health.dailynewscentral.com/content/view/896/62
• http://www.nytimes.com/2006/01/10/health/10cons.html
• http://scienceline.org/2008/11/19/health-joelving-birth-control-pill-plus-testosterone/
• http://www.project-aware.org/Resource/articlearchives/testosterone.shtml
• http://www.aphroditewomenshealth.com/news/20020311214759_health_news.shtml
• http://www.eu-digest.com/2009/04/baltimoresuncom-sex-health-happiness.html

(87.192.128.174 (talk) 19:14, 7 July 2009 (UTC))

The pill's effect on libido is discussed in the side effect subsection sexuality. The effect on smell is discussed under other effects.

The specific study on SHBG levels is not currently in the article. (The first few links all refer to the same one study. The later links talk about women's sex drive and testosterone without specifically mentioning the pill, while the last one talks about sex among the elderly without mentioning either the pill or testosterone.) While this study may be incorporated into the article (the study itself should be cited - PMID 16409223 - not a journalist reporting on the study), it should remain clear that it is not accepted as accurate by mainstream medicine. Lyrl^Talk _C 23:01, 7 July 2009 (UTC)

A 2011 survey of the worldwide scientific literature by the World Health Organization’s International Agency for Research on Cancer concluded with their highest level of confidence (Category 1) that: "There is  sufficient evidence in humans for the carcinogenicity of combined estrogen–progestogen oral contraceptives. Combined estrogen–progestogen oral contraceptives cause cancer of the breast, in-situ and invasive cancer of the uterine cervix, and cancer of the liver.

For cancer of the endometrium, ovary, and colorectum, there is  evidence suggesting lack of carcinogenicity. An inverse relationship has been established between exposure to combined estrogen–progestogen oral contraceptives and cancer of the endometrium, ovary, and colorectum.

There is sufficient evidence in experimental animals for the carcinogenicity of several combinations of estrogen–progestogen used in oral contraceptives.

Combined estrogen–progestogen oral contraceptives are carcinogenic to humans (Group 1).”

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 100A (2011) http://monographs.iarc.fr/ENG/Monographs/vol100A/index.php

A Review of Human Carcinogens: Pharmaceuticals:  Combined Estrogen–Progestogen Contraceptives <http://monographs.iarc.fr/ENG/Monographs/vol100A/mono100A-18.pdf>

Also note that Hypertension is the heightening of blood pressure, not lowering as stated in this article —Preceding unsigned comment added by 123.243.196.35 (talk) 06:26, 23 March 2011 (UTC)

24-July edits

An editor recently made a number of copyediting changes to this article (diff). Some of these changes improved the readability of the article, and I appreciate the editor taking the time to do these copyedits. However, I reverted a few of the changes:

• I changed all instances of "side-effect" to "side effect". Every dictionary I consulted (Mirriam-Webster, Definr, Wiktionary) showed the correct usage to be a space between the words, not a hyphen. Adding many hyphens to articles has been an issue with this editor before, and it was discussed at the Manual of Style: Wikipedia talk:Manual of Style/Archive 96#Hyphens. While few people participated in that discussion, the consensus seems to be against such use of hyphens. Wikipedia follows convention in grammar, not logic.
• The Wikipedia Manual of Style says, "Values and unit symbols are separated by a non-breaking space." I put non-breaking spaces between values and units to bring this article in compliance with this Wikipedia guideline.
• According to Mirriam-Webster's definition of "who", definition #2, the word who is used in place of the word that when referring to a person. I made this change in three sentences.

In addition to those three reversions, I made additional copyedits to the article:

• I removed extraneous wording from the lead.
• I broke a long sentence describing a chemical reaction and the source of the raw material into two sentences: one sentence describing the source material, followed by a second sentence describing the chemical reaction.

The editor restored their version of the article, which included reversion of my copyedits unrelated to the three items I reverted, with the explanation "logic" (diff). As I have explained here, to me their action was not logical. I would like to understand the basis for the edits; perhaps we could come to an understanding on this issue. Lyrl^Talk _C 18:51, 24 July 2009 (UTC)

With due respect, I put forth that the "undo" on my edits of this referred page is a demonstration of nonrecognition of what the Wikipedia Manual of Style has intended on the respective issues, not to mention the logic of language, resulting in incorrect edits.

• The discussion on the spelling of side-effect is past wearisome within Wikipedia, especially with those that neither understand language and its history nor take the time to research the very dictionary sources that they cite. The dictionary is not a bible on language, but rather a reporter on the usage of language, both correct and incorrect. The written word was innovated to reflect the meaning of the idea, and English, because of its Anglo-Saxon ancestry, has affinity for transferring the accent of a word or group of words to its primary syllable when the idea becomes a one-word idea. That is, we now make distinction between mail man and mailman, each with its current distinct meaning, the former of which pronounced with equal accentuation of both syllables, the latter of which pronounced with accent on the first syllable, reflecting the one-word idea. In similar manner, our current pronunciation of side-effect with accent on side illustrates that side-effect is, in fact, complying with Anglo-Saxon tradition of the spelling-idea relationship, and, therefore, its transitional spelling, cited at various dictionary and reference sources: http://dictionary.reference.com/browse/side-effect.
• In support of the concept, the above-stated sentence "I appreciate the editor taking the time to do these copyedits" reflects the tendency of historical English to take the two substantives copy and edit and fuse them, rendering a spelling reflecting the meaning of a one-word idea, also reflected in the pronunciation, whose accent is on copy. [Moreover, the sentence is illogical: You do not appreciate me, but rather my taking the time. So the corrected statement, denoting the meaning trying to be conveyed by the speaker/writer, is: "I appreciate the editor's taking the time to do these copyedits."]
• It is the case that, in the phrase "A dose of 5 mg of norethindrone," a space between the value 5 and the unit mg is required because 5 is a modifier of the substantive mg. So the spelling of the words complies with the meaning conveyed, which is reflected through the modifier-substantive relationship. However, from the same article, in "a 5-mg [or 5mg] dose of norethindrone," there must not be a space between 5 and mg because the one-word idea represented by 5-mg is itself an adjective modifying the substantive dose. In like manner, no edit was performed on the phrase "21 pills are taken," but an edit was required on the phrase "28-pill packet," illustrating through spelling the modifier-substantive relationship, rendering the correct statement: "For the 28-pill packet, 21 pills are taken..."
• In general, as the dictionary cites, who refers to people, and which, contracted form of who-like, refers to non-people, but not in an indiscriminate manner; that is, who refers to people, but not all people are expressed as who (all oranges are citrus fruits, but not all citrus fruits are oranges). That, however, is a relative pronoun that (note: not which here in order to make distinction between the relative pronoun that and other relative pronouns) enables English speakers and writers to distinguish between two scenarios. From the article, in its incorrect form:
  

"... in women who have a familial tendency to form blood clots"

should be stated in order to reflect the meaning intended by the author

"... in women that have a familial tendency to form blood clots"

so that "women that have a familial tendency to form blood clots" can be differentiated from "women that do not have a familial tendency to form blood clots." It should be noted that the meaning of "...Women who have a familial tendency to form blood clots" can be taken as "all women, in general, have a tendency to form blood clots," not the intended meaning by the author. Various dictionary sources reflect the historical usage of that in this manner. Drphilharmonic (talk) 00:21, 25 July 2009 (UTC)

You are correct in representing your views as having a logical framework. If I understand correctly, your belief is that "side-effect" is a transitional form that will become the norm in the future, and that in the further future the correct form will be "sideeffect" or some similar rendering without any space or hyphen. If this comes to pass, "side-effect" should be the form in the future version of this article. In the current version of this article, however, the current normative practice should be followed. The current normative practice is to have a space between the words.

Wikipedia's MoS appreciates that many number/unit combinations are one-word ideas. Its approach to this situation is to put a non-breaking space between these combinations. In cases where the number is a modifier of the unit, the non-breaking space is not required. Your logical argument in favor of hyphens over non-breaking spaces is something to bring to the Manual of Style talk page, not this one. Again, for the current article the current version of the MoS should be followed.

There is an important difference in meaning between "... in women who have a familiar tendency to form blood clots..." and "... in women, who have a familiar tendency to form blood clots, ..." The first sentence will not be mistaken for the later sentence by any significant number of readers. While "that" is just as grammatically correct as "who", "that" often has a negative connotation when used to refer to a person.

Also, did you have an objection to my modification of the lead paragraph or my dividing the long sentence about saponin origin and processing into two sentences? I ask because you reverted these changes. Lyrl^Talk _C 00:56, 25 July 2009 (UTC)

There is no objection to the clarification of the lengthy sentences of the lead paragraph.

Non-breaking space versus the hyphen is irrelevant; the point is that the value-unit term should not be two words if together they comprise a one-word idea that modifies the substantive. It should be understood very well by writers of English that "a dose of 5 mg" equates to "a 5-mg dose" or "a 5mg dose," and "a period of 12 hours" equates to "a 12-hour period."

Note that "side-effect" is offered as a current alternative spelling in the various dictionary and reference sources above-referenced, whose usage is reflected in many Wikipedia articles. Drphilharmonic (talk) 04:11, 25 July 2009 (UTC)

The Manual of Style is irrelevant?

I am used to debates on whether edits are in line with Wikipedia guidelines. If your belief is that Wikipedia guidelines are subordinate to your personal opinions, there is not any common ground on which we can meet. Lyrl^Talk _C 11:28, 25 July 2009 (UTC)

It is not a matter of personal opinion, but rather a matter of abiding logic and the Wikipedia Manual of Style. Try to be receptive of both my meaning and that of the Wikipedia Manual of Style, which offers the non-breaking space in the value-unit relationship with respect to the modifier-substantive relationship. That is:

"a dosage of 5SPACEmg" is written in this manner - with forced space - because 5 is an adjective that MODIFIES the substantive mg. The same phrase, as is described by the Manual of Style, which should be understood by those that put pen to paper, equates to "a 5HYPHENmg dosage" OR "a 5NO-SPACEmg dosage" because the entity 5-mg OR 5mg is an adjective that MODIFIES the substantive dosage.

This is the point that I claim to be irrelevant: that of hyphen versus no-space, not hyphen [or no-space] versus space, because whether one spells the substantive print-out or printout today is a matter of personal preference, for the word whether spelled with hyphen or no-space is a compound word whose meaning is a one-word idea, but a space is enforced in the verbial printSPACEout. So we print out a print-out [or printout]. Note, also, the difference in pronunciation between the verbial, whose accent is equal on both syllables, and the substantive, whose accent is on print, moreover lending credence to the discussion on side-effect.

The same logic and writing style from the Wikipedia Manual of Style apply to the following:

"a period of 12SPACEhours" [wherein 12 modifies hours]

equates to

"a 12HYPHENhour period"

OR

"a 12NO-SPACEhour period" [wherein 12-hour OR 12hour modifies period].

The Wikipedia Manual of Style in no form states that a complete washing of terms of the value-unit relationship be conducted to employ a forced space between the value and the unit irrespective of the relationship between the value and unit. Therefore, again, in abiding both logic and the Wikipedia Manual of Style, the phrase

"a dose of 5 mg is recommended" is correct

as are the phrases

"a 5-mg dose is recommended" and "a 5mg dose is recommended"

but the phrase

"a 5 mg dose is recommended" is incorrect. Drphilharmonic (talk) 18:06, 26 July 2009 (UTC)

I don't think we're going to convince each other on the issue of hyphenating a compound word. In your example of printout, I would consider "print-out" to be incorrect in a Wikipedia article.

We both find our interpretations of the MoS to be obvious. I think the wording of the MoS should be modified to prevent disagreements such as ours; I have started a discussion on this and hope you will join in with your opinion. Lyrl^Talk _C 22:44, 26 July 2009 (UTC)

I believe Drphilharmonic's attempt to apply the logic and grammar of the English language to quantities such as "5 mg" is misguided, because "5 mg" is not part of the English language, it is part of the International System of Units (SI). Unlike the English language, which is guided by a consensus of English-speaking individuals; SI is governed by an entity created by international treaty, the General Conference on Weights and Measures, as interpreted and enforced by the authorities of each nation. In the case of the United States, SI is interpreted by the Secretary of Commerce and that interpretation is embodied in NIST Special Publications 330 and 811.

On the other hand, the relevant treaties and interpretations allow language-dependent variations when the names of units are spelled out, so normal logic and grammar of the English language would apply to "five milligrams". --Jc3s5h (talk) 23:33, 26 July 2009 (UTC)

Drphilharmonic has been asked in the past, by myself and by others, to comply with the house style and the conventions of standard English instead of with his own personal (i.e., logically consistent) notions. The previously addressed issues line up very neatly with the complaints here.

I'll add, however, that Drphilharmonic does not introduce any grammar errors in preferring that instead of who (both of which can be correctly used in these sentences). He is merely being rude and violating the principles behind WP:RETAIN by imposing his personal preference instead of following the system established in the article. WhatamIdoing (talk) 23:38, 27 July 2009 (UTC)

Canada

1. The reference to the quiet revolution, just above this section, probably belongs in it.

2. The reference to Alesse should be to its website, www.alesse.ca, which shows its provocative T-hirt designs. Cobylub (talk) 16:47, 8 September 2009 (UTC)

interaction

i wanted to find out if Combined Oral Contraceptive Pills (COCP) interacts with choloroquine and ketoconazole or not. —Preceding unsigned comment added by 113.199.254.160 (talk) 08:38, 24 May 2010 (UTC)

Breast cancer risk review

http://www.medicalnewstoday.com/articles/175394.php was posted 07 Jan 2010. It is a report on a 2009 study by Jessica Dolle (et al. of the Fred Hutchinson Cancer Research Center) which concluded "that women who start OCs before age 18 multiply their risk of TNBC by 3.7 times and recent users of OCs within the last one to five years multiply their risk by 4.2 times." TNBC being "an aggressive form of breast cancer associated with high mortality." Does this merit a revisal of the "Cautions and contraindications" section? —Preceding unsigned comment added by 207.5.151.71 (talk) 16:51, 10 June 2010 (UTC)

scientific findings/iarc/ stroke journal/etc

I will be including the findings that are found here:

http://stroke.ahajournals.org/cgi/content/abstract/33/5/1202

Conclusions— Third-generation oral contraceptives (containing desogestrel or gestodene) confer the same risk of first ischemic stroke as second-generation oral contraceptives (containing levonorgestrel).

http://www.iarc.fr/en/media-centre/pr/2005/pr167.html

http://www.iarc.fr/en/media-centre/pr/2005/pr167.html

An IARC Monographs Working Group has concluded that combined estrogen-progestogen oral contraceptives and combined estrogen-progestogen menopausal therapy are carcinogenic to humans (Group 1), after a thorough review of the published scientific evidence.At the same time, the Working Group stressed that there is also convincing evidence that oral contraceptives have a protective effect against some types of cancer.There are both beneficial and adverse effects for oral contraceptives and menopausal therapy. Each woman who uses these products should discuss the overall risks and benefits with her doctor. The Working Group, comprising 21 scientists from 8 countries, was convened by the IARC Monographs Programme of the International Agency for Research on Cancer (IARC), the cancer research agency of the World Health Organization.

http://jcem.endojournals.org/cgi/content/abstract/90/7/3863

In conclusion, a rigorous meta-analysis of the literature suggests that current use of low-dose OCs significantly increases the risk of both cardiac and vascular arterial events, including a significant risk of vascular arterial complications with third generation OCs.

• Kleinbell (talk) 02:28, 12 September 2010 (UTC)

For the last article the rest of their conclusion goes on to say that.

"The modern use of low-dose OCs, limited to healthy women and restricted in time, should not increase noticeably the incidence of these adverse outcomes, which might be outweighed by the benefits of contraception. However, prolonged exposure to low-dose OCs in a population at higher risk may significantly increase the incidence of cardiovascular outcomes and prompt consideration of alternative therapeutic or contraceptive interventions."Jean-Patrice Baillargeon, Donna K. McClish, Paulina A. Essah, and John E. Nestler (2005). "Association between the Current Use of Low-Dose Oral Contraceptives and Cardiovascular Arterial Disease: A Meta-Analysis". Journal of Clinical Endocrinology & Metabolism (The Endocrine Society) 90 (7): 3863–3870. doi:10.1210/jc.2004-1958. PMID 15814774. http://jcem.endojournals.org/cgi/content/abstract/90/7/3863.  Zodon (talk) 07:26, 6 October 2010 (UTC)

Thanks for this. The term they used is should and might and so these are hopeful and tentative words in comparison to the categorical scientific conclusion above. Klughilton4 (talk) 03:22, 7 October 2010 (UTC)

No idea what you mean - they are all part of the conclusion, they are no more tentative than the rest, and they provide necessary context to understand what the finding means in practice. Zodon (talk) 05:26, 7 October 2010 (UTC)

NPOV problems

This article now (Oct 2010) has big NPOV problems. Coverage of cancer is way out of balance, needs to give perspective/compare risk to other risks (e.g. of not using contraceptive or using less effective contraceptives), and magnitude of cancer effect. When dealing with something with as much emotion tied with it as cancer just saying it is carcinogenic is sensationalizing. (Many chemicals in everyday things like cosmetics and air fresheners are carcinogenic. Just like saying something is poison - it is always a question of dose. How much, etc.)

Likewise coverage of cardiovascular risk needs more balance. Most women in the age groups that take OCs are not at much risk of stroke/MI, so the risk while elevated is still very small (compared to other preventable risks, or to common risks like driving a car).

The coverage of mechanism of action was way out of balance also, with addition of what appeared to be original synthesis of material giving undue weight. Zodon (talk) 05:16, 6 October 2010 (UTC)

I have reworked it to improve these issues, but out of time at the moment.

The coverage of cancer still needs less generality and more what cancers, how much, compare to other risks. (Less general quotes.)

Coverage of cardiovascular still needs some work.

Need to improve arrangement to separate actual contraindications from general risks.

Put the mechanism back to a previous more neutral state, think that part mostly dealt with for moment. Zodon (talk) 07:18, 6 October 2010 (UTC)

I added a "cite needed" in your statement on "The controversy is currently unresolved." What I wrote was based on mere chronology, and so I thought it was better and more neutral. Can you kindly give me a reason why you think your version is more neutral? I can see that it makes Wikipedia take a stand (without any citation), while my version, does not make Wikipedia take a stand. It only informs the public what is the latest in a peer reviewed journal of the American Medical Association, which has a very high credibility and notability character.

I will also add a "cite needed" in the phrase "small increase" in some cancers. Kindly give the basis for this statement, since the IARC did not make that qualification.

I also do not understand the removal of all the lede points, including the abortifacient issues. Kindly explain. Thanks. Kleinbell (talk) 08:44, 6 October 2010 (UTC)

Since you reverted my edits, it would be nice for us to be reminded of this and this.

From what I know of my edits, I have been merely quoting, so I do not understand your comments about "sensationalizing" and "original synthesis." Kindly explain further. Kleinbell (talk) 09:02, 6 October 2010 (UTC)

Thanks to Prari for bringing back my edits on mechanism. =) However, I am still not in agreement with this phrase: "Other possible secondary mechanisms have been hypothesized." The latest respectable data shows quite categorically that there is no hypothesis involved but that ""the medical literature does not support the hypothesis that postfertilization effects of OCs do not exist." So it will be obvious to readers that Wikipedia has taken a stand and is in fact contradicting actual studies. Sorry, Wikipedia is Wikipedia... Klughilton4 (talk) 03:01, 7 October 2010 (UTC)

Klughilton4 - On what basis do you object to "Other possible mechanisms have been hypothesized?" The second quotation you give says nothing about whether such effects exist or do not, or whether they have been hypothesized or not. (Just because something can't be ruled out doesn't mean it exists, Etc.)

Even if such mechanisms had been proven to exist (which they haven't) it would still not contradict that they had been hypothesized. Zodon (talk) 05:14, 7 October 2010 (UTC)

Lead - already covered risks and benefits in the information box, no need to repeat them. The lead is supposed to summarize major points - possible (and debated) secondary mechanisms of action, minor secondary effects, etc. are not major points. Expanding coverage of them in the lead doesn't follow standard for lead and suggests undue weight. (WP:lead) Zodon (talk) 05:14, 7 October 2010 (UTC)

Cancer

I agree that citation/more detail needed on cancer. It must perforce be small because if it was huge then would not have a net decreased mortality, would have questions of pill safety, etc. As I indicated in my original comment, to just say carcinogen is meaningless without saying what cancers, how much, etc.

To say something is carcinogenic might be thought to mean that it poses a major increased risk of cancer. Like saying that water is poisonous. In fact, water is poisonous, however the LD50 is so high that this is not usually a major concern. So to just say it is a carcinogen without qualification/explanation is potentially sensationalizing - making something appear more significant than it is. Hence moving away from WP:NPOV. Zodon (talk) 05:14, 7 October 2010 (UTC)

Found one citation on small - already in the article. PMID 8656904 Zodon (talk) 07:03, 7 October 2010 (UTC)

Mechanism

Putting together items from different sources and claiming that they form an "evolution of ideas" is original research, and is specifically prohibited on Wikipedia. See WP:NOR, specifically WP:SYNTHESIS. Mere chronology does not prove relationship (consider Post hoc ergo propter hoc).

What sources support the view that this is an evolution/change of idea/view (as compared to different individuals or groups holding differing opinions, for instance)?

Don't know what you mean about making a stand - just saying that different opinions exist does not take a stand for or against any of them. Claiming that this is an evolution of ideas suggests that the later ideas are more widely accepted, have supplanted or refute the previous ones, etc. (Hence less neutral.) Just because something is recent doesn't mean it is more widely accepted (often converse is true), or better researched, etc. Zodon (talk) 05:14, 7 October 2010 (UTC)

Moved point of view of author to here

For the 2006 study on SHBG in the sexuality section, I removed the following text, because I doubt it is encyclopaedic to have so much text dedicated to study authors' comments, which are not necessarily neutral point of view, especially in this case where a 2007 study (mentioned earlier in that section) didn't find a change in sexual satisfaction.

The study called for prospective research. However, study author Dr. Irwin Goldstein indicated that this study followed "7 years of observational research in which we noted in our practice many women with sexual dysfunction who had used the oral contraceptive but whose sexual and hormonal problems persisted despite stopping the birth control pill," Lead author Dr. Claudia Panzer stressed that doctors prescribing the Pill should "point out to their patients potential sexual side effects, such as decreased desire, arousal, decreased lubrication and increased sexual pain. Also if women present with these complaints, it is crucial to recognize the link between sexual dysfunction and the oral contraceptive and not to attribute these complaints solely to psychological causes."

Mikael Häggström (talk) 16:43, 22 July 2011 (UTC)

Percy Julian yet again

Reverted inappropriate Percy Lavon Julian edits (and WP:Copyright violations) by anonymous 71.182.100.111 / 71.240.244.35 editor (aka 141.149.208.54 / 71.123.29.191 / 71.182.123.65 / 71.123.17.215 / 71.182.107.102 / 70.16.52.193 / 70.16.61.75). See: Talk:Combined oral contraceptive pill#Percy Julian again. Percy Julian did not play a role in the history of the Pill. Lynn4 (talk) 21:41, 19 February 2012 (UTC)

I reverted the reintroduction into the History section of two paragraphs of WP:Copyright violations and WP:OR by anonymous editor 71.123.31.25 (aka 141.149.208.54 / 71.123.29.191 / 71.182.123.65 / 71.123.17.215 / 71.182.107.102 / 70.16.52.193 / 70.16.61.75 / 71.182.122.21 / 71.182.100.111 / 71.240.244.35).

WP:COPYVIOs:

In the 1930s chemists recognized the structural similarity of a large group of natural substances—the steroids. These include cholesterol, bile acids, sex hormones, and the cortical hormones of the adrenal glands. The medicinal potential of various steroids quickly became obvious, but extracting sufficient quantities of steroids, which exist in minute amounts in animal tissue and fluids, was prohibitively expensive. As with other scarce or difficult-to-isolate natural products, chemists were called upon to mimic nature by creating these steroids in the lab, and later by modifying them to make them safer and more effective as drugs. Chemists found starting materials in certain plant substances that were also steroids. Percy Lavon Julian (1899–1975), Russell Earl Marker (1902–1995), and Carl Djerassi (b. 1923) were among those scientists who participated actively in the synthesis and large-scale production of steroids—both cortisone and the sex hormones—from plant compounds.^{[http://www.chemheritage.org/discover/online-resources/chemistry-in-history/themes/pharmaceuticals/restoring-and-regulating-the-bodys-biochemistry/julian--marker--djerassi.aspx]}

Percy Lavon Julian is most noted for his synthesis of cortisone from soybean sterols used to treat inflammatory conditions such as rheumatoid arthritis which laid the foundation for the steroid drug industry's production of corticosteroids and birth control pills.^{[http://www.ars.usda.gov/research/publications/publications.htm?seq_no_115=215771]}
The soy stigmasterol was easily converted into commercial quantities of the female hormone, progesterone, and the first pound of progesterone he made, valued at $63,500 was shipped to the buyer in an armored car!^{[http://lipidlibrary.aocs.org/history/Julian/index.htm]}

WP:OR (see: Talk:Percy Lavon Julian#USDA "recognition" of Percy Julian and Talk:Soybean#USDA "recognition" of Percy Julian):

It took the USDA until June 13, 2008 to recognize Dr. Julian; Giants of the past: Percy Lavon Julian, a forgotten pioneer in soy.^{[http://www.ars.usda.gov/research/publications/publications.htm?seq_no_115=215771]}

Lynn4 (talk) 18:34, 20 February 2012 (UTC)

Clinical trials in Puerto Rico

The first tests in Purto Rico were done without informing the women that they were the guinea pigs. It was one of the biggest medical scandals of the 20th century. I think this is worth mentioning! Some info on that can be found here: http://www.thebatt.com/2.8485/anger-over-puerto-rico-s-pill-test-lingers-1.1205789 and here: https://elbohemio.wordpress.com/2007/06/07/puerto-rico-and-the-advent-of-the-pill/ 178.114.10.140 (talk) 17:29, 24 February 2012 (UTC)