23. "What Your Doctor Doesn't Tell You"

In 1963, the Upjohn Company applied for a permit to begin testing Depo-Provera for use as a contraceptive. By 1974, the Food and Drug Administration was on the verge of approving its use only when all alternative methods had failed and when the woman did not want any more children. But pressure from the Health Research Group -- a Ralph Nader organization and from Congressional hearings prompted the FDA to withhold even limited approval pending further studies on the drug. Subsequently, the FDA informed Upjohn that Depo-Provera was not an approvable drug for contraception because of its risks.

Tests indicate that the drug has caused breast nodules in dogs, some of which are malignant, and it increased the risk of cervical cancer, and could possibly cause cervical sterility, severe depression, loss of hair, irregular bleeding or prolonged lack of menstruation.

However, the drug had been approved for treatment of uterine cancer.

Nonetheless, Depo-Provera is a drug prescribed by doctors as a contraceptive. Since it is approved for the treatment of uterine cancer, the drug can be dispensed.

Physicians prescribing it for birth control point out that it is the most widely used hormonal contraceptive outside the U.S., that over 60 countries approve it for such use, that it is effective, easy to administer, and requires little patient responsibility. (It is administered in the form of a shot once every three months.)

A 1977 survey of 50 Los Angeles gynecologists revealed that 15 prescribe Depo-Provera as a contraceptive:

Equally disturbing to the questions about the safety of the drug, is the failure of physicians to inform women about the known risks of Depo-Provera.

Interviews with 150 women who were prescribed the drug showed that 81 percent had not been verbally informed that the drug was anything but a standard contraceptive; 80 percent were not told of its possible link with sterility; and 96 percent were not told of its link with cancer. Many respondents reported that their doctors merely described it as "new."

The questionable ethical behavior of the prescribing physicians and the media's failure to publicize the issue qualifies this story for nomination as one of the "best censored" stories of 1978.

SOURCES:

New West, August 14, 1978, p. 78, "What Your Doctor Doesn't Tell You," by Diane Swanbrow.

McCall's, January, 1978, p. 39, "The Facts About a Controversial Contraceptive."