01/20/2014 05:04 EST | Updated 03/22/2014 05:59 EDT

Is Birth Control Keeping up With Women?

These days it takes a shot of tequila and a box of tissues to get through the daily newsfeed. This is especially true when the headlines hit close to home. Or at least it was for me when I learned of the class action lawsuit against the makers of NuvaRing scheduled for trial this month.

According to reports, plaintiffs' claim the flexible vaginal contraceptive ring can cause severe blood clots damaging the lungs and organs. They also claim that sometimes these clots lead to death and that Merck failed to adequately communicate the risk of deep vein thrombosis to consumers -- a risk some researchers believe is 1.4 to 4.0 times higher than "the pill" because of third generation progestin.

Shot glass at the ready, I email the article to my husband under the subject heading: "Well, shit."

This report has me feeling discouraged, scared and celibate. It also got me thinking about the bigger picture. Like many women, I've been cycling through birth control methods like prophylactics, "the pill," "the shot," baby roulette -- which is exactly what it sounds like, and now NuvaRing for more than half my life. A revelation that occurs to me shortly after learning of this and similar lawsuits brought against contraceptive manufacturers like Yasmin and Ocella. Google if you dare!

I wonder if the mounting health risks compounded by prolonged use of hormonal contraceptives will land more women in the courthouse, the hospital or the ground? I wonder why more of us aren't talking about this?

Who is She?

Picture a 15-year-old girl. She is sexually active (responsible) and begins using birth control. She's not thinking about it now, but she is likely to continue filling that prescription until she is "ready for kids." Baby-time happens between 25 and 36 (or older) and shortly after Junior arrives she is back on birth control until...more babies, divorce, vasectomy? Who knows? Responsible, sexually active 15-year-old turned successful, well-traveled 30-something mom, has now been on the hormonal contraceptive teat for some 15 years. This scenario is common -- deal with it!

Women who delay having children could be on one form of birth control or another for up to 20 years or more. For those who opt out of motherhood altogether, birth control may only end when menopause begins. Really? These are our options?

Before we all run off to get our tubes tied, let's pause to review our history: we haven't come as far as we think.

In 1957, after decades of R&D, the birth control pill is finally approved (in the United States). It is only available to women diagnosed with "menstrual disorders." Predictably, an epidemic ensues. In 1960, we get "permission" to use "the pill" for contraception pitting unprecedented control of our reproductive systems against the social constructs of the time (many of which endure).

Menstrual disorders aside, for the past 50 plus years, women have assumed the health risks (and often the costs) of birth control to avoid (duh!) getting pregnant. But hormonal contraceptives haven't kept up with our needs. Somehow it's more complicated than ever.

Yes, I am aware there is risk in everything

No matter the method, all birth control is fraught with risks and side effects. While some research suggests that long-term use of the pill can increase the risk of cervical cancer, liver cancer and glaucoma, others find no link at all. At the same time, we know for sure that the pill can reduce the risk of ovarian and endometrial cancers. Now, I believe that life is all about trade-offs but it shouldn't take a systematic review team to get a clear picture of the risks and long-term health implications.

Meanwhile a billion-dollar industry churns, the stakes for women are high and subscriptions to medical journals remain expensive. So we just keep rolling the dice and hoping for the best -- at least that's what I do.


10 Must-Know Birth Control Facts