Friday, April 26, 2013

Finding information on the Internet, Part 1

The Internet is full of information.

All you have to do is type a question into Google, (or even just start to type a question into Google and it will fill out the rest for you), and a plethora of answers will be returned to you in a matter of seconds. Then all you need to do is point and click, and viola! Right?


But how do you know that the answer you found is right?

Anyone can contribute information to the Internet. A high school student, a Walmart greeter, a post-doctoral researcher, but how do you know who's information you should trust. You might think, 'The post-doctoral researcher, of course!' But what if the information you're looking up is about employment practices at Walmart. Then, wouldn't the person working as a greeter be able to provide some valid information? Not to mention, maybe the post-doctoral researcher's specialty is in paleontology so even if they wrote about Walmart in a blog, discussion board, or on a Website, what makes their information more accurate? Is it even accurate?

As a librarian, I'm trained in finding information. As a librarian for a medical research group, my specialty is finding information related to healthcare. Normally, when I'm looking for information I'm searching for large quantities of journal articles, conference abstracts, reports, etc., that are relevant to a specific aspect of medicine, or healthcare. When I do this I have access to a large number of databases and electronic journals (the exact figure is surprisingly difficult to find), whereas the average Internet user doesn't.

Over the next couple of blog posts, I'm going to talk about finding and evaluating information on the Internet. I'm not sure how many posts this will take up, but I'll use my series on oral contraceptives and amenorrhea to help illustrate my points. Either way, I hope my faithful readers will find it helpful.


Wednesday, April 24, 2013

What is amenorrhea?

Next up in the discussion, amenorrhea. What is it, and just exactly how do you say it?

Amenorrhea (said: a-men-o-REE-uh) is the absence of menstruation. According to Williams Gynecology 2nd Edition, there are a couple of different situations for which amenorrhea can be diagnosed. The first two are in the case of young girls who haven't started to menstruate by a) 14 years of age and are showing no other sides of puberty; or b) 16 years of age with other signs of puberty visible. Obviously this isn't my case. The third definition is for females who had previously been menstruating, but missed menses for 3 cycles in a row, or 6 months.

The most common cause of amenorrhea is pregnancy, but again, this isn't my case.

If you look through the links you'll find a variety of reason for why amenorrhea occurs. Included among them are use of oral contraceptives, discontinuation of oral contraceptives, sudden weight loss, low body fat percent, and extreme amounts of exercise. Related, there is condition called Female Athlete Triad syndrome, where female athletes involved in sports that emphasize low weight (i.e. gymnastics, figure skating, diving, long distance running, etc) can experience a combination of: eat disorders, amenorrhea and decreased bone mineral density (for more information on this condition, see Female Athlete Triad Coalition Website).

Other causes of amenorrhea include: other medication use (chemo drugs, antipsychotics and antidepressants), hormonal imbalances (especially the thyroid, but also the pituitary gland), and structural abnormalities with the reproductive organs themselves.

Here is a link to the Mayo Clinic pages on amenorrhea (click through the tabs for more information):

Here is to the UptoDate page on amenorrhea (this may require a password or subscription):

Here is the MedlinePlus page on amenorrhea:

Here is the Wikipedia page on amenorrhea:


Wednesday, April 17, 2013

What do oral contraceptives do?

The way the birth control works is fairly straight forward. Okay, so I'm sure controlling the hormones involved isn't so simple, but the affect on a woman's body is fairly easy to understand. From what I can tell, it plays out the same way whether you're on a combination pill (estrogen and progestin), or the minipill (progestin only).

(Sorry, I haven't really talked about the difference between the combination pill and the minipill. Having to research my posts takes way more time than just throwing my thoughts all slap-dash together in a few paragraphs.)

Basically, when a woman takes an oral contraceptive, it causes the mucus in her cervix to thicken, while thinning the lining of the uterus, preventing an egg to implant there. Taking an oral contraceptive can also prevent ovulation all together. Simple, right? Hm.

Here's a website from the Association of Reproductive Health Professionals that has a nice animated graphic on how menstruation works and how it's affected by different birth control methods:

Here's a link to the Mayo Clinic's resources on oral contraceptives:

Here's a link to a fact sheet by the American Collage of Obstetricians and Gynecologists on the pill:

Here's a link from the Women's Health Resource Center, which is run by a non-profit organization called Healthy Women

Finally, once again I give you the Wikipedia page on how oral contraceptives work (do you see a theme emerging?):



Saturday, April 13, 2013

The Pill and my period, full stop, Part 2

Interestingly enough, after my first blog post where I talked about my lack of period, I had a couple of people come forward and talk to me about their own experiences. It seems like, because this has to do with things of a womanly nature the natural instinct is to kept it private. Yet, because no one likes to talk about periods, no one realizes others have gone through the same things.

Here are a couple of the things I heard:

The first person to talk to me, told me that after going off the pill she didn't have a period for over a year. Cripes! There were perhaps some confounding factors in her case but still, not menstruating--the quintessential function that makes a woman and woman--for such a long time, it must have been frustrating, if not stressful.

Another friend sent me a message and described some of the negative affects she experienced while on the pill. That friend developed lumps in her breast, which appeared to be due to her use of oral contraceptives. Can it get more frightening for a woman? I can only imagine the first through of someone upon finding breast lumps and it must be terrifying.

I can think of a third instance where a cousin of mine suffered a stroke in her late 20s/early 30s, most likely due to her extended use of birth control. Strokes are usually a threat to the elderly, or people with cardiovascular conditions. Not young woman taking birth control.

Now, I don't mean to scare anyone off birth control pills. If I've learned anything from my job about medical research, it's that a few anecdotes of unconnected people doesn't amount to evidence. Of course, safety data on medication is difficult to collect as it often requires long time frames and most drug trials are of short duration. Overall, oral contraceptives are effective, but it's important to know the risks you take when you take any kind of medication.

Next week I'll provide some information on how the birth control pill works.



Thursday, April 11, 2013

The history of oral contaceptives

As promised, today I'm going to provide a little history behind the development of oral contraceptives, or the Pill. I don't feel it's necessary to re-write the facts out in detail, but I hope the links below will be useful and provide some insight into how the pill came to be.

In short, humans have tried to control fertility dating back to the Greeks. The mechanics of how pregnancy occurs, however, wasn't discovered until the late 1800s. The earliest commercially available forms of birth control include materials such as diaphragms and suppositories, which were introduced in the 1890s.

In the 1930s, scientists started to understand that high doses of steroids such as androgen, estrogen, and progesterone prevented ovulation. At first these hormones were synthesized from animals, but due to the high cost of production alternative methods were tested, and eventually were extracted from Mexican yams. Further investigation into the use of progesterone to prevent ovulation began in the 1950s, including trials of treatments in women beginning in 1951. By 1957 the FDA approved the use of a drug called Enovid for use in menstrual disorders (the use of birth control wasn't permitted by law for some time yet).

Reports of side effects of the pill began to circulate in 1962 (including blood clots and heart attacks). Throughout the remainder of the 1960s data was gathered on the safety of the pill, culminating in the mandatory addition of a patient safety sheet to birth control pill packages in 1970. By the 1980s new, lower hormone doses of birth control became available.

Journal of the History of Medicine:
This article provides history om the development of the pill.

This site provides a variety of information, from history, to how the pill works.

CBC Digital Archives:
This link provides a look at the history of the pill from a reproductive rights standpoint.

American Chemical Society:
This link provides history on isolation of progesterone for prevention of pregnancy.

The wikipedia article on the history of the pill, easy to read, but never the first line for information.


Tuesday, April 9, 2013

Recall alert for birth control pills

Since I'm currently writing a series on oral contraceptives, I thought I would post this alert for a recall in all provinces of Canada (except Saskatchewan and Alberta) for Alysena-28 manufactured by Apotex. The code on the packages subject to the recall is: LF01899A. The recall has been issued because there may be two weeks of placebo pills rather than one.

The link to the CBC news story is here:

More information on the recall from Health Canada can be found here:



Saturday, April 6, 2013

The Pill and my period, full stop

Since I discuss just about everything going on in my life on this blog, I'm going to go a bit more personal for the next few posts. You might wonder, after tearing apart my personality, how could I get more personal? First, let me reassure you, dear reader, that what I'm going to discuss isn't ichy or scary or depressing, but it is of a...womanly nature? Further, I've decided to share this because I expect there are other women out there who have undergone similar problems, and being a librarian, I would like to provide helpful information.

Here's the big share:

I used the oral contraceptive Marvalon for seven and a half years. It was fine. I didn't experience any major side effects, my periods were always very light, mainly just a regular monthly irritation. Late June 2012, I decided it was time to go off 'the pill.' I'd had enough of ingesting extra hormones, and Andrew and I were starting to talk more seriously about the possibility of having children. Therefore, it seemed like a good time to stop.

Okay, so?

So, I haven't had a period since. That's closing in on ten months, and I'm really, really not pregnant. Nor have I been at any point since last June. I also dropped eight pounds in about two months--I know this sounds great, except I didn't change anything diet or exercise wise (I know, I track it all), except that I stopped taking Marvalon.

I'm experiencing something called post-pill amenorrhea. Amenorrhea is the absence of a period in a woman (who had hitherto been menstruating) for more than three months. Opinions seem to vary as to how quickly a woman's period should come back after using the pill, possibly because it varies from woman to woman. However, I am definitely on the long side of normal at this point and I am seeing a doctor to try and get this sorted out. I'll touch on that later.

Here's what I'm going to do over the next couple of posts.

1. I'm going to provide some history on the pill.
2. I'm going to provide some information on how the pill works.
3. I'm going to provide some information on amenorrhea.
4. I'm going to provide some information on what can be done to treat amenorrhea.

For the most part, I'm just going to provide links to information, with a short summary on each topic. I'm not an expert in this field, and there's plenty of information out there so that I don't need to regurgitate it all here.


Tuesday, April 2, 2013

Circus is pain

Have you ever seen a Cirque de Soliel show? Did you marvel at how beautiful and daring the performers were?

I'm going to let you in on a little secret. Circus is painful, or as I often like to say: 'Circus, it's surprisingly painful!' A common question upon learning a new move (especially a drop) is: does it hurt? And then: how much does it hurt? And then: Does it hurt more than <insert move here, usually Double Bubble>?

Andrew and I stopped doing trapeze because it hurts. Think about it, you're sitting/standing/hanging on a metal bar with no padding but your own skin and muscle. I've heard it said that hoop hurts even more. No thank you. With silks and rope, you often tie up your feet in knots, then stretch yourself in unusual directions. Then there are drops. Again, you tie yourself up in some fancy wrap, then you LET GO (either with a leg or a hand) and jerk to a stop. Circus produces some interesting bruises...

I don't have much experience to compare aerials to other performance arts with, but I have spent time figure skating. Figure skating only hurts when you do something wrong, like fall. Jumps and spins don't hurt while you're doing them, although I suppose some pairs or dance moves might be more uncomfortable.

What's brought on this post, you might ask? Andrew and I took a private lesson yesterday to learn some double/duo aerial moves. It hurts even MORE than regular aerials. I suppose this should make sense. It's not just your own body weight pulling against the bar of a trapeze (which we learned the first basics on), or the live ends of silk, it's someone else's body weight too. Oi. I have some interesting discoloration coming out today.

So, after this one might wonder why anyone would want to do aerials. My answer: despite all the discomfort IT. IS. AWESOME. As I wrote not long ago, I love performing drops. The whoosh (and the rush) as you go from the top to the bottom of the room. Also, you just get used to the discomfort. It's a little like developing a taste for a food that you didn't like at first. You do it (or eat it) enough, and you get used to it.