In response to Martha Gill’s compelling, well-researched commentary on decades-long stagnation of research into contraception, I would add that it is alarming that – accompanying rising disenchantment with contraceptive pills – there is a well-documented drift towards increased use of the rhythm method of contraception (“The pill hasn’t been improved in years. No wonder women are giving up on it”, Comment).
This method has widely and misleadingly been promoted as “natural”. It is based on the simplistic notion that a menstrual cycle follows a reliably regular pattern, which I call the “egg-timer model”. The core assumption is that ovulation occurs only during a four- to five-day period in mid-cycle, known as the fertile window. The rationale of the rhythm method is that conception can be avoided by restricting coitus to the remaining, non-fertile cycle days.
In cases where conception occurs despite use of the rhythm method, according to the egg-timer model this is most likely to result from an ageing sperm fertilising a fresh egg, or from an ageing egg being fertilised by a fresh sperm. In either case, an increased risk of miscarriage or abnormal foetal development is expected. In fact, objective surveys have revealed that the failure rate of the rhythm method is high (exceeding 20% in practice). One reason for this could be the little-studied phenomenon of long-term storage of sperm in the neck of the womb.
Prof Robert D. Martin, Emeritus Curator, the Field Museum of Natural History, Chicago, Illinois
Women must not be gaslit regarding the potential consequences of hormonal birth control on mental health. Anxiety and depression are not uncommon side-effects and for some can have serious consequences, especially if health professionals deny that synthetic hormones may be the cause and do not act swiftly to offer alternatives.
It is true that hormonal contraceptives do not affect all women this way, but since we have no reliable way of knowing who may be negatively affected, we must be open with women that this is the case and that hormones may not suit everyone. We must also believe and support those who report extreme changes in mental state after commencing treatment.
We must of course also ensure young women are aware of the risks of using untested cycle tracking apps promoted online. It is possible, with the right education and tools, to avoid pregnancy without hormonal birth control. Unfortunately, this requires a different approach and investment in women’s health, which I’m unsure health services currently have capacity to deliver.
Miriam Avery, mental health nurse
Manchester
Trump’s real mission
Your editorial is correct to say that “a dangerous new international order is unfolding” (Comment), but Donald Trump hasn’t acted for no gain for himself and his backers.
Slowly and skilfully over the last decade, the billionaire class has worked to delegitimise the slow process by which America’s democracy widened inclusion and diversity. Simultaneously, capitalism stripped millions of working-class Americans of the rights to an affordable roof over their heads, to decent healthcare and access to higher education. Then, vast sums were spent by those billionaires on the Trump campaign with its racism, misogyny and intolerance, and then his administration’s attacks on policies for “inclusion and diversity”.
Do not be fooled. Trump and Elon Musk are not cutting the government budget, bureaucratic waste and excess. Nor are they slashing the deep state and the global American security apparatus.
Acting on behalf of “lending institutions and moneyed incorporations”, they are demolishing the slow, regulatory process of holding back rampant, extractive capitalism. They are hacking away at democracy – both at home and abroad.
David Murray
Wallington, south London
A war footing is vital
Andrew Rawnsley summarises very clearly the options available to Sir Keir Starmer as he prepares to go to the White House at this pivotal and indeed terrifying moment (“What can Keir Starmer say at the White House that Donald Trump might listen to?”, Comment, last week).
I feel strongly that our government should be bold and forward thinking and put itself and the country on the equivalent of a war footing. It needs to push through fast a raft of measures to improve our self-sufficiency, especially in food, energy, and defence. As we did in the Second World War.
They need to hold cross-party brainstormings, initiate a blitz of public information to get the whole country engaged and involved. Act fast. This could bring the country together. We left Europe and the US has left us, we are alone and we need to come together, work together. Good could come out of all this horror.
Freya Hartley
Torquay
Animal suffering is rife
Marion Rowe is right to point out how shocking it is that farmed prawns have their eyestalks cut off, causing them pain and, of course, making them blind (Letters, last week). Sadly, mutilations are commonplace in today’s animal farming.
Dairy and beef cows are dehorned, and male beef calves castrated. It is commonplace for an egg-laying hen to have the tip of her beak sliced off without anaesthetic, while still a chick. Lambs have their tails docked and the males are castrated. Animal Aid urges people to boycott the products that result from all this suffering, by choosing a vegan diet.
Iain Green, Director, Animal Aid
Tonbridge, Kent
Rich pickings
It may interest Catherine Bennett (“Elon Musk’s four-year-old son blended in perfectly in the Oval Office with all the other bogeymen”, Comment) to know that many of the earliest books written for children sought to encourage good conduct, and were particularly hot on the issue of nose-picking.
Thanks to Katherine Rundell, the award-winning children’s author, I learned that the 15th-century Little Children’s Little Book warned children not to “wipe your nose or nostrils, else men will say you are come of churls”. How prescient.
Joan Lewis
Latigat, St Étienne de Gourgas, France
The absent sausage
Nigel Slater’s mouthwatering recipe for sausages with spinach and cannellini beans was accompanied by a succulent full-page photograph (Magazine, last week). However, it depicted only five sausages, while the recipe indicated six. Am I the only one who wants to know what happened to the other one?
Verne Sanderson
Tenterden, Kent
