Pre-Menstrual Dysphoric Disorder (PMDD) and Birth Control, A Dangerous Combination

From “Taking Charge of Your Fertility” by Toni Weschler

From my previous posts you have learned that I don’t oppose all forms of birth control, but that I urge caution about hormonal birth control.

I have two reasons for this: the first is the fact that hormonal birth control can be an abortificant. The second is much more personal, hormonal birth control can really create havoc on your body and mind.

Shortly before we were married, my wife went to her gynecologist for a routine check and pre-wedding screening (not like she needed it but whatever). While there, the doctor told her she should start taking birth control a couple of months before the wedding. “You don’t want to be inconvenienced by a baby.” she told her. Being young and naive my soon to be wife acquiesced and started taking what the doctor prescribed.

The side effects began her first week on the pill. At first it was a near constant nausea which kept her in bed most of the time. Next, a nearly insatiable libido disappeared. Then came the depression and anxiety. She reported these to the doctor and was assured they weren’t side-effects, she was probably just nervous about the wedding.

Reluctantly, the doctor switched her pills for the patch. Her nausea abated slightly, but the rest of the symptoms remained in full force.

By the time the wedding came, she had very little interest in sex. There were a few nights on the honeymoon where she cried for hours because she couldn’t understand what was happening to her. She didn’t want me anymore. What sort of switch happened that would cause her to suddenly stop her interest in me?

Upon our return, my new wife reported these problems to the doctor only to be told that she was probably just regretting her decision to get married so young. “Depression is not a side effect of birth control.” Nonetheless, her doctor agreed to change the medication again, this time to the Nuva Ring.

While the ring was better for nausea, the depression worsened dramatically. There were nights I would wake up next to a sweating, rocking, tearful woman. Sex was nearly impossible. She contemplated suicide.

All the while, the doctor insisted it was in her head.

I don’t remember exactly what clicked in my mind, but one morning I told her to quit the birth control. While the side-effects weren’t spelled out on the packaging, it was too suspicious to me that they would coincide with her first dosages. She quit taking them, much to her doctor’s chagrin.

Within a month her mood was vastly better. Her nausea disappeared. There were still incredible mental and emotional scars that made sex difficult, but her appetite for it returned in force. Two months after quitting (three months after the wedding), she was pregnant.

After our first daughter was born we ignorantly decided to try the BC again. Breastfeeding was a hellish nightmare (thanks to a lack of lactation consultants) and parenting did not seem like something we wanted to do more of at that point.

Side effects came right back full force. She was told “oh, those aren’t side effects” yet again.

Funny how they disappeared shortly after she stopped taking the pill for the second time.

The labels did vaguely mention that you could have suicidal thoughts as a side-effect. But it was listed as an almost unheard of side effect. Our only guess is that women who do not suffer from Pre-Menstrual Dysphoric Disorder (PMDD) rarely have those side effects. Or that doctors simply don’t care.

She was never screened for PMDD, we didn’t know she had it until almost ten years later. But the diagnosis made everything make sense. Any fluctuation in hormones brings about emotional and mental changes in her. Birth control, pregnancy, and breastfeeding each had their own effects, whether nausea or severe depression or decreased libido. Like clockwork she gets severe depression about ten days before her period and starts feeling better immediately upon menstruation. Then she is healthy for a week or so after, before plunging back down again.

Most doctors don’t even know what PMDD is, it’s just not on their radar. They are convinced that BC simply doesn’t have any emotional side effects. They barely listened to her about the nausea.

It’s almost like they have an agenda to push. Hence the “you don’t want to be inconvenienced by a baby” comment.

Needless to say, hormonal birth control is definitely not for us. Since this happened to us we have talked to dozens of women who had similar experiences, even ones without PMDD.

If you decide to use it and you experience similar side effects, don’t let the doctor tell you that you are crazy or that you should just switch until you find one that works. Get your hormones checked and talk to a doctor about the possibility of PMDD. It took a general practitioner about ten minutes to make the diagnosis and prescribe medication and other therapies. Now she is healthier emotionally than she has ever been.

It’s not worth living in misery when there are other ways to go about preventing pregnancy.

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Killing the Seed: How Hormonal Birth Control Violates the Sixth Commandment

avacoado

In my previous post I talked about how I don’t believe sperm by itself is a “seed” and therefore I don’t believe that birth control methods which block sperm are immoral in and of themselves. Today I’d like to talk about how a fertilized egg is a seed.

If we continue the analogy of conception being like sowing seeds in a garden, the fertilized egg is what is “planted” in the uterus. The fertilized egg (zygote), unlike a sperm, has a very real potential of growing into an adult.

Most “pro-choice” people will argue that life does not begin until some magic moment such as the first breath or even later. But logic concludes that two living cells do not come together to form a non-living blob of tissue. The sperm is alive, the egg is alive, therefore the fertilized egg is alive as well. Not only is it alive, it contains its own unique strand of DNA. It is not identical to its mother or its father. Nor is it a mutation like cancer. Thus the zygote is a living person and under the requirements of the Sixth commandment, should be protected as such.

Unlike sperm, the fertilized egg is not just a potential life, it is a life. And without the next step of implantation that life will end. Blocking the zygote from implantation ends that life.

Most birth control pills and the IUD work primarily through preventing ovulation or fertilization, but in the rare instance that these mechanisms fail they also have the effect of making the uterine walls inhospitable to implantation by the fertilized egg.

In recent times, politically charged “science” has called into question whether this is actually one of the mechanisms of hormonal birth control. We actually know very little about how the pill works, we know it prevents ovulation, we know it prevents sperm from reaching egg, and we know it thins the uterine lining or changes the chemical environment of the uterus. Given the third one it makes sense to err on the side of caution and assume that it also prevents implantation of the “seed”.

And even if we consider it a slim possibility that the egg will be released, then fertilized and then make it to the uterus, this slim possibility that one will be responsible for the death of another human being should be enough to persuade us to avoid these methods.

Many will argue that if we reach my conclusion we will also have to assume that natural miscarriages are sinful too. What makes the elective abortion different from the natural miscarriage?

This should be obvious, one is willful, the other is not. A woman who naturally miscarries cannot be help morally culpable for the death of her child, she was most likely not in control of the situation that led to the miscarriage.

Stay tuned next week for an analysis of side effects…

*I realized after I was almost done writing this that one could conclude that I am calling all users of hormonal birth control sinners. Please be assured that you are not a part of this category if you are abstaining from sex and taking birth control for reasons other than contraception.

A Few Explanations

Lest I be accused of misrepresentation, I do want to clarify a few things about Onanism.

Onanists do understand that Onan was deliberately disobeying God. They do not simply conclude that the spilling itself was the whole of Onan’s transgressions.

The implications of what they believe are quite staggering. While most don’t believe there are any reasons to prevent pregnancy, there are some who will allow it. However, because of their interpretation of these verses, they often assert the only moral way to prevent pregnancy is complete abstinence, even in marriage. I know a man who has gone twelve years without intercourse because he refused his wife’s request to have a vasectomy. He considers it his cross to bear. It’s almost like a badge of honor to him. I think it’s a shame. I think it is atrocious that he has allowed his wife to withhold from him (sin) for this long without approaching her as a brother in Christ or as a Godly husband concerned with his wife’s soul.

They also don’t go officially by the name “Onanist”, I just coined the term to describe those who hold to this particular application of the Onan story. So don’t go pointing a finger and yelling “Onanist!” at them. They probably wouldn’t understand anyway.

Don’t be this guy…

Every Sperm is Sacred: Onanism and Birth Control

Every Sperm is sacred
Every Sperm is Sacred… Wait, that’s the Catholics… Source

You may want to send your kids into the next room for the next couple of posts, I’m going to talk about sex. In particular about birth control. Is birth control a sin? Is it wise? Can it harm you?

Personally, we do not use hormonal birth control, but ours is less a conscience issue and more of a personal experience issue. I’ll discuss later in this series, but first I want to address a common objection to birth control often thrown around in Reformed circles: The story of Onan.

And Judah took a wife for Er his firstborn, and her name was Tamar. But Er, Judah’s firstborn, was wicked in the sight of the Lord, and the Lord put him to death. Then Judah said to Onan, “Go in to your brother’s wife and perform the duty of a brother-in-law to her, and raise up offspring for your brother.” But Onan knew that the offspring would not be his. So whenever he went in to his brother’s wife he would waste the semen on the ground, so as not to give offspring to his brother. And what he did was wicked in the sight of the Lord, and He put him to death also.
Genesis 38:6-10

According to the Onanists, the mere spilling of a man’s semen outside of a woman’s body is a sinful thing. The birth control methods of coitus interruptus (stopping before orgasm), pulling out, or even vasectomy are ruled out as violating the principle found in the story of Onan.

Just reading the story of Onan is not enough to find these principles. One has to dig into commentaries and discussions written centuries ago.

Before one questions my Reformed credentials, old commentaries are helpful when studying the essentials of our faith. They are helpful for learning Godliness and how to live a Holy life. But, sometimes even the men of the past show their fallibility.

“….the third [murder], in that there is a seminal vital virtue, which perishes if the seed be spilled; and by doing this to hinder the begetting of a living child, is the first degree of murder that can be committed, and the next unto it is the marring of conception, when it is made…” -Westminster Annotations and Commentary on the Whole Bible (1657), Genesis 38:9.

“Most Hebrew and Christian commentators conclude [from the grammar] that the sin of Er was of the same type as the sin of Onan, which they call effeminacy. Augustine in book 22, Against Faust Chap. 84, concluded that this Er had sinned in this offense severely because that sin impedes conception and destroys the foetus in its own seed….” – Lutheran minister Johann Gerhard (1582-1637)

“The rabbis interpreted Onan’s transgression as birth control through coitus interruptus. In an illustrative euphemism, the Jewish commentator Rashi calls this “threshing within, winnowing without.””

Given the terminology used by the commentators I think it is safe to assume that the interpretation of past generations was based on a belief that the man’s sperm was a fully formed seed. In fact, the KJV translates verse 9 as:

And Onan knew that the seed should not be his; and it came to pass, when he went in unto his brother’s wife, that he spilled it on the ground, lest that he should give seed to his brother.

This seed was planted into a woman’s body, much like planting a vegetable seed in a garden. To spill the seed was murder as the spiller was denying the living seed the opportunity to sprout and grow.

The 6th commandment requires us to protect life. Even potential life should be protected. If we assume that a man’s emission is a fully formed seed it is reasonable to conclude that wasting this emission is in fact ending a potential life.

In order to answer the question “do spermicidal or barrier birth control methods violate the 6th commandment?” we have to answer this question: “is sperm in and of itself ‘potential life?’”

My answer to this is “no”.

Semen is not a seed, sperm is not a seed. Without an egg present there is no chance that the sperm will survive. Unless the sperm fertilizes an egg it will die. Yes, the sperm is a living cell, but it does not carry by itself the potential for new human life.

Unless a woman is ovulating there is no potential for that sperm to grow into a life as it will never contact an egg. It will simply swim around inside the woman for a few hours or days and eventually die.

If we had to ensure sperm survived sex (the logical conclusion of Onanists), we would limit sexual union to only the time in which a woman is ovulating. Any sex outside of that time of fertility would be denying that “seed” a real opportunity to grow into life. You would be robbing that sperm the opportunity to meet and fertilize an egg.

We are commanded to give our spouse their conjugal rights, surely our spouse wants this fulfillment outside of the ovulation period, are we therefore being commanded to commit murder every time we do it any other time?

God would not command us to violate His own commandments. He knew that eventually we would know the science behind ovulation and understand the cycle of fertility. He allowed us to discover these things. The logical conclusion of the Onanists would have us use this knowledge to limit intercourse to those fertile times, otherwise we are “wasting” our “seed” just as Onan did.

Whether or not you believe barrier methods of birth control are sinful or not is not an indication of your salvation. This is a matter of conscience and I don’t hold it against anyone if they come to the conclusion that they personally cannot use barriers, coitus interuptus, or vasectomies in good conscience.

But for the reasons above, I don’t consider them sinful.

Stick around for the next post when I discuss why I believe hormonal birth control is sinful.