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Seasonale: Fooling Mother Nature

Is there anything about the human body that medicine should not try to alter? When it comes to women’s bodies the answer apparently is no.

Is there anything about the human body that medicine should not try to alter? When it comes to women’s bodies the answer apparently is no. Medicine is more than ready to fool with Mother Nature.

A new study reports that there has been a 20 percent jump in elective Caesarean sections. These are not C-sections chosen by women when natural childbirth proves too difficult. Rather, these are surgeries for women who are scheduling them simply for the sake of convenience.

As one mother-to-be told one of the researchers, “Our vacation is important to the entire family and I would rather have the birth over with than ruin that for everybody.”

Elective C-sections are not the only recent example of medicine being used to undermine the natural. The Food and Drug Administration is expected to rule in the next few weeks on whether to allow a new pill to be put on the market that will reduce the number of menstrual cycles women experience. Instead of having their periods once a month, women who take Seasonale would have only four periods a year — one in the spring, summer, fall and winter. Get it? Seasonale!

Doctors have long known that women who take birth control hormones do not menstruate. The reason that birth control pills are supposed to be taken for 21 days with a break for a period is that the original manufacturers wanted to make birth control pills seem more “natural.” They also knew that having a period allows a woman who is trying to avoid pregnancy know that she is not pregnant.

But today birth control pills already seem “natural.” And there are easy-to-use test kits to see if you are pregnant. So who needs menstruation?

While many women would like to be rid of the inconvenience of periods, should it be part of medicine’s job to help women time their births to fit a busy schedule or to get rid of a messy and sometimes painful monthly experience? Like it or not, the answer seems clear: Say goodbye to menstruation.

Most doctors would agree that C-sections are worse for moms and babies than natural childbirth. But that concern has not slowed the explosion of elective C-sections. And, despite the fact that there are no long-term studies on the side effects of suppressing menstruation, it is very likely that Seasonale will soon be approved by the FDA.

Just as elective C-sections become the norm, the advent of Seasonale illustrates how medicine is increasingly willing to let the patient decide what is and is not appropriate when it comes to taking health risks.

And it’s not just about patient’s choice. As long as there is big money to be made doing elective surgeries, the rate of elective C-sections is likely to continue to climb. Similarly, you can bet there will be a big market for Seasonale. There is a lot of money to be made selling it — and few women are going to wax nostalgic about missing their period.

Medicine is poised to change the very nature of what is natural. When money and convenience are allied with what medicine can offer, Mother Nature does not stand a chance.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania in Philadelphia.