Korean Medical Association: Don’t Take the Pill!

All the contraceptive pills are gone...(Source: Surija / “Sray”; CC BY 2.0)

Why not? Well, because Korean women are stupid apparently, unable to do so much as read the instructions and numerous warnings about possible side-effects that come with the product, let alone do their own research and make their own choice about what contraception is best for them personally.

Or at least, that is the more benign reading of this warning from the KMA, and to be fair, given such factors as Koreans’ general reluctance to self-diagnose and be proactive about treating any medical condition that they might have themselves, and many Korean women’s complete reliance on men to use contraception, then at first glance there is nothing to distinguish the top-down, patronizing but also paternalistic tone of the KMA in the warning as any different from any other Korean institution’s relationship with the Korean public. In reality however, in its bias and scare-mongering it demonstrates an explicit and almost sinister vested interest in maintaining the huge abortion industry here.

No, really. That may sound like hyperbole, but then the Korean state already has a long history as an extremely invasive and coercive force in Koreans’ reproductive lives, its population policy in the 1960s and 1970s only slightly less draconian than that of China’s today, at many points having soldiers withdrawn from the DMZ at the height of the Cold War to deliver IUDs and perform abortions in the Korean countryside for instance (see this book for more on that). And such industry-related claims are also widely acknowledged of Japanese health authorities (albeit not so much in Japan itself), which banned the pill for three decades and which Japanese women are still scared of using, so why not of Korea ones too?

But regardless of that background, how else are we to interpret the evidence from just the KMA’s warning alone? Consider that:

  • It provides no information about possible side-effects that I didn’t already know about 10 years ago (and I’m a guy remember), which begs the question of why the Korea Times considered it “news” exactly.
  • It literally doesn’t provide a single positive medical benefit of using them, and naturally the Korea Times fails its most basic of journalistic duties by not providing them either.
  • It implies that somehow there is somehow something unique to contraceptive pills and not, say…amphetamines that makes women’s access to them in much more urgent need of being restricted.
  • And finally, that in a country where double-standards, moralistic pharmacists and medical staff, virtually non-existent sex education, and a lack of access already combine to severely limit women’s sexual confidence and choices of contraception in practice (see here)…surely it is telling that the most senior medical institution in the country is literally scaring women away from using the single safest and most effective contraceptive in human history?

Actually, I do agree that there are some benefits to women of, say, requiring a prescription from a doctor to get the pill, one poster in this forum (which I give a hat tip to for some of the above) pointing out that it means many women will usually get gynecological examinations at the same time, wheres they wouldn’t have bothered otherwise. But, one should always be very careful to acknowledge the different contexts in which they occur, and I dare say that most young British women buying contraceptives, for instance, are not asked by pharmacists if they’re married, or alternatively the same by doctors and nurses rather than a more neutral, non-judgmental inquiry as to if they are sexually active. To require a prescription in those circumstances would surely mean that many women simply wouldn’t go to get them all, which renders quick and easy access to the pill, albeit online if you don’t look 25 or older, one of the very few positives about Korean sexual culture (source, right: NEWSis).

Ending on another positive note, all trends in Korea point to continued increased use of the pill over time, and I’m not merely seeking brownie points among my readers when I say that I do have confidence in Korean women even just considering the pill not to be swayed by “warnings” like this. Given how, as I explained in my last post on the subject, half the battle is getting many Korean women to take an active role in using contraception at all, then merely thinking about all the pros and cons of the options available is an important first step. And of those that have done so, then I dare say that from that point on they will apply a more discerning eye to the ravings of groups like the KMA!

Update: In case anyone wants it, here is the original warning in Korean too.

24 thoughts on “Korean Medical Association: Don’t Take the Pill!

  1. That KT article is either grossly irresponsible or at the very least completely out of touch with common medical knowledge that exists in Western countries. Birth control pills are now in what’s referred to as the third generation and have never been safer.

    You hit the nail on the head with the fear-mongering observation. More and more I’m beginning to realize that a basic lack of medical knowledge amongst the general populace creates a cozy breeding ground for whichever interested group to perpetrate irrational and incomplete truths to the advancement of whichever industry or business they are a part of. I recently had a medical experience where my doctor plainly tried to pull the wool over my eyes. My partner and I both required antibiotics but I was told I would need ‘extra’ medications because ‘a woman’s body is different from a man’s’; read ‘ka-ching’. I have next to no expert knowledge of medical things but being quite clear on the basic functioning of antibiotics I immediately called bullshit on this quaint explanation.

    This lack of basic knowledge causes ‘regular’ people to be unduly afraid and worried about basic medical issues and can in turn lead to people misusing medications, which of course can be very dangerous. I’m pretty sure I was quite clear on how the pill worked from high school since I did receive clear and unbiased information on contraception in sex ed class. Furthermore, when I wanted to take the pill myself as a teen, there was no moral judgment from either my mother or my doctor (I do have a very liberal family mind you) and certainly no judgment by the pharmacists who filled my prescriptions.

    In some ways requiring a prescription might instill the idea that contraceptive pills are a little more complicated that aspirin, but again with the moralizing medical and pharmaceutical professionals it would be a concern that this would further discourage women from choosing the pill. I hope that Korean women can be proactive enough to seek out basic medical knowledge for themselves so they can confidently make safe decisions about their own bodies.

  2. crud! I was finally inspired to post again and you’ve beaten me to the punch!
    I’m willing to cut the KT a little slack because technically they were covering the release by the KMA, not the actual benefits and hazards of the pill . . . but it is still incredibly sloppy reporting.

  3. i’m sure there will be alot of opinions on this matter, due to how repressive korean culture is with sex, but growing up in the west and east, it’s pretty blatantly obvious how sexually frustrated koreans within korea are. albeit, sexual education and the introduction to the western openness of sex is still relatively new and unexplored compared to the US/Europe for example. however, you are correct in how inane KT and the general media is about sex.

    to be honest, despite overgeneralizing this matter, it’s pretty obvious it’s a tug war within modern korean society in terms of the method of embracing and education sexuality. last thing they want is the “awful” and “raunchy” western definition of sex to permeate through the minds of young people, thinking that we’re going to a AIDS ridden country (i still hear from koreans how white people brought STDs into asia).

    • Ann: Well put, leaving me little to add unfortunately! Without you revealing too much information of course, it would be interesting to hear exactly how you called BS on the doctor and what his or her reaction was.

      Regardless, I’ve just realized as I typed that why it’s of course bad that Korean doctors deliberately mislead patients for the sake of selling them extra and unnecessary drugs, it’s hardly unique to Korea. On the other hand, it’s just plain bizarre that they’re still so full of antiquated and dangerous notions about the human body, despite many decades of a generally Western, evidence-based medical education. From this hilarious post I did already know that Korean traditional medicine at least was like that, dissuading me from ever stepping in a clinic despite a certain curiosity about it, but a normal doctor in a developed country talking and thinking like that? In 2009?

      I think the endurance probably lies more in the endurance of a doctor’s unquestioning authority over patients here, with the former telling lies so often that they become more and more believable to the doctor him or herself. Baltimoron discusses this more in a forum post expanding on this topic here, which I highly recommend reading.

      Gomushin Girl: Sorry! And I was waiting for a (long overdue) post too!

      Charles: I’d have to agree with Baltimoron here: it’s not about sex per se, but is just one manifestation of the heavily skewed and fundamentally flawed doctor-patient relationship here (again, I recommend his forum thread). That doesn’t mean that the points you make about Korean sexual mores aren’t still valid though.

      • On the other hand, it’s just plain bizarre that they’re still so full of antiquated and dangerous notions about the human body, despite many decades of a generally Western, evidence-based medical education.

        This assumes that Western evidence-based medical education actually works as advertised. How many medical discoveries (if not most) were accidental or unintended? What you’re really talking about is preference for uncertainty and risk. If I am reading you correctly, you are saying that Western evidence-based medical education PROVES that it is generally safe to be on the pill. Is this necessarily the case? It would appear the KMA is projecting a very different position because their risk-aversion on the so-called evidence-based medicine about the pill is much moe conservative and robust to uncertainty. If you’re interested, check out the medical decision-making literature, particularly concerning the epistemology of scientific claims.

        • Sigh. Not only have you completely missed the point Right Said Fred, but as per usual you’re putting words in people’s mouths again.

          Anne said that her doctor claimed that she needed extra medications simply because “a women’s body is different to a man’s.” Granted, it is, but one suspects that he or she didn’t go into details, and also that the motivation was selling more medications for the sake of personal profit

          My point was that if it wasn’t simply a way to sell medications to (normally) gullible,ill-informed and accepting patients, then it displays a bizarre, almost medieval conception of the human body. Men’s and women’s bodies are different, at least to the extent that the latter needs extra medications because…well, just because. I feel so, so it must be true.

          That’s a relatively innocuous example of course, but as that post from the Party Pooper I linked to ably demonstrated (unfortunately now defunct), Korean medicine as a whole (still heavily influential on Western-trained doctors) is premised on concepts of the human body no more substantive than Western concepts of the zodiac. Hell, it’s scary considering how many people buy into and are even harmed by this bullshit. But hurray for the placebo effect, yes?

          • Here is some more interesting excerpts: http://dancewithchance.com/excerpts/nationalpuzzles.html

            I know you may not be interested, but I deem it relevant, and perhaps some of your other reader may enjoy it too! Thanks. :)

            Medical researchers and statisticians have always had problems explaining the data for certain countries. Take Japan, for instance. The Japanese per capita consumption of cigarettes is among the highest in the world, yet Japanese life expectancy is also the highest (at least for larger countries). If the British results, which – if you remember – give non-smokers a ten-year edge over smokers, were applicable, Japanese women, 41% of whom smoke, could expect to live an extra four years on average. That would take them up to an incredible eighty-nine-year life expectancy. Overall life expectancy in Japan would exceed eighty-six, if both men and women didn’t smoke. And if we could rule out all the other risk factors, Japanese life expectancy would rise to well over 100 on the basis of table 2.

            In the international smoking league tables, the first place goes to Greece, while Norway has the smallest per capita cigarette consumption in the developed world. Yet life expectancy in Norway is only three and a half months longer than in Greece, a country where physical exercise is famously unpopular and where hospital access is patchy – many islands don’t have hospitals at all.

            What about high-fat diets and cholesterol intake? France is perhaps the most well-known paradox in this respect. Life expectancy in Metropolitan France is more than eighty years – the tenth highest in the international rankings – although the French diet is notoriously rich in fat. If we go into further detail, we find that deaths from cardiovascular disease are lower than in other nations (39.8 per 100,000 as opposed to 196.5 per 100,000 in the USA). In particular, Périgord, the region in south-west France famous for producing the high-cholesterol delicacy foie gras, has a particularly fatty diet, with plenty of butter, and duck and goose products. Yet life expectancy is higher than in the rest of France and cardiovascular death rates even lower. Back on the national scale, if we compare France to Norway, we find that per capita cigarette consumption is 2.8 times higher in the former, and fat intake significantly lower in the latter. But – you guessed it – the French live on average about a year longer than Norwegians. The only possible conclusion is that there must be factors other than smoking and cholesterol to explain the difference in life expectancy between France (and in particular Périgord) and the USA, Norway, or many other developed nations, where public health campaigns against these two “vices” have had more effect.

            By focusing entirely on the negative aspects of the risk factors – and the worst-case scenarios at that – these public health campaigns tend to raise falsely positive expectations about how we individuals can improve our chances of living longer. The message may be that “doctor knows best.” But the deeper we dig into the evidence, the most charitable interpretation is the “doctor is telling us to be on the safe side.” And, strangely, there’s been comparatively little medical research about why the Japanese, Greeks, and French live longer than medical research suggests they ought to. If we’re going to make reasoned choices about how to live our lives, we need more objective and accurate cost-benefit analyses of the many different activities that influence longevity.

  4. Personal anecdote: I’m going to Thailand with my (Korean) girlfriend in a month. In planning (neurotically) our trip I realized I should ask her about vaccinations as she has never been to the tropics or a third world country. I discovered that she has no General Practitioner and her way of dealing with my suggestions was to say ” I’ll go to the hospital to get some shots” which she never actually did. I brought it up a couple more time but I give up. I see a general lack of self responsibility – American influence? Still living at home even though she’s almost 30? I’ve asked a number of other Koreans – they have no GP’s. Of course, I don’t have a doctor (although, I haven’t lived in the same place for 29 years) but I’m an EMT and my condition has to be pretty serious for me to see a doctor – unless I’m in a “modern country” and I need a prescription. Every time someone gets a cold they have to go to the hospital. Is this the only country in the world where convenience stores don’t sell painkillers/cold medicine? How can someone blindly trust a doctor? With the internet, it is so easy to research any medical information. aggghhhh…..

  5. I’d like to make another comment related to the doctor’s milking of patients under false premises, and this is in regards to the typical order of things when people come down with the common cold or flu.

    Anyone who’s lived here at least a year knows that when you catch either of these, you ‘go to the hospital’ whereupon you are given ‘a shot’. As far as I know and also what others seem to confirm, that shot contains (possibly among other things) antibiotics. Again, anyone with a basic (Western?) high school level of science should (hopefully) recall that colds and the flu are viruses and thus untreatable with anything other than rest and perhaps OJ or chicken soup (though cold ‘medications’ go a long way to alleviate symptoms – oh Nyquil I miss you).

    Administering antibiotics to a cold ridden person is completely medically incorrect and as far as I’m aware, likely contributing to a rather severe worldwide problem where the misuse of antibiotics is leading to more virulent antibiotic resistant bacteria. A few Korean sources have mentioned that apparently the government is aware of this misuse but apparently little has been done about it because these shots are still certainly de rigeur. I’m sure they also plump up the doctor’s salary significantly as basically everyone is guaranteed to come down with a cold or the flu at some point.

    What I’d like to know is exactly what sort of concoction these shots are, and I’d also be interested to see some actual documentation/articles on the extent to which this situation is recognized by official bodies.

  6. Thanks for both of those, and sorry I took so long to reply. Unfortunately I don’t really have much to add to either, expect for a quick anecdote and an even quicker question to Sonam:

    1) what’s an EMT?

    2) As I explain in this rather old post now on Korean medicine that I linked to earlier, I think the whole “going to the hospital” for every trivial cough and sneeze is at least partially because until 2000, doctors and pharmacists could give prescriptions and sell medicines. I don’t know if you were also here then, but regardless I remember the change in policy quite well because quite a few of my students were medical students, and a great many doctors were striking because ( I think) they could no longer dispense medicines personally and were not being compensated for the loss of income…which all led to a lot of lively debates in class.

    Anyway, before the change to the doctor-prescribe-pharmacist-sell policy like in most Western countries (as far as I am aware), if I could have either shuffled along to the pharmacy to get my medicine and, say, explained a rash in my nether regions in front of other customers, or shuffled along to the hospital and got a private diagnosis from a doctor at the same time instead, then I’d probably have done the latter too. And it’s no great surprise that the accompanying mindset – and whole industry structure of ubiquitous little clinics has little changed in the 9 years since.

    For a personal anecdote of my own, until I knew this I never understood why my “I had to go to the hospital” excuse for missing a coffee for the second time was reason enough for an acquaintance/budding Korean friend to break off all contact with me many years ago. Say that excuse in NZ then you get instant sympathy and concern given that NZers only go in dire emergencies, which was indeed the reason I went in this case too, but understandably she didn’t think too much of it. Probably for the best though!

    Okay, maybe not so quick after all…

  7. The KMA is not being patronizing; they’re being responsible. The pill is not something that anyone (a woman, that is) should take anytime they feel like. There are a lot of risks for women that many in the general public are not aware of, including strokes and special dangers related to smokers. Simply put, it is a danger for this potent and potentially harmful medicine where one size does NOT fit all to be offered as an over-the-counter remedy.

    The KMA is right about making this a prescription-only drug, as in most advanced countries. It is the Korea Times that gets it wrong, saying that the KMA is warning women off it in general when what the KMA is doing is saying that you should take it only after a doctor’s consultation and their okay.

    And an EMT is an emergency medical technician, no?

    Anne, I’m not so sure if those chusa shots still contain antibiotics. Starting in the latter half of the 1990s, the KMA and other organizations were going through a huge push about the problems of overuse of antibiotics, especially when they were nothing more than “potent placebos” (my term for the practice). In fact, nowadays, I’ll bet they might be nothing more than caffeine or sedatives, depending on the patient’s complaint, but that it NOT something I’m certain of.

    I was actually going to blog about the whole issue of birth control pills, since this is a subject in my public health studies and a focus of my future dissertation on Korean health practices, but I had missed the KT article, so thanks for that.

    • Kushibo, Forgive me if this sounds a little blunt, but it does appear that you wrote your comment without reading much – if any – of the original post. I did acknowledge that there are some advantages to requiring women to get a doctor’s subscription for instance, but argued that in the Korean context of inadequate sex-education, restricted access to contraceptives for unmarried and/or young-looking Korean women, sexual double-standards that discourage women taking personal responsibility for contraception, and finally moralizing and patronizing attitudes by pharmacists and heath-care professionals, then in the balance I thought that literally anything that increased women’s control of their sexuality was a positive. Given the factors that I mentioned, then requiring a doctor’s prescription would in practice simply mean that many women would simply stop using the pill at all.

      I also argued that Korean women are fully capable of learning about risks of the pill and of making the decision to use it or not for themselves; it’s not like they’re a secret, nor worthy of singling the pill out for. You’re entitled to have a different opinion of course, but you haven’t prevented any evidence to persuade me to change mine.

  8. Interesting stuff, as always (of course, I’m a bit late to the party here). Here’s my two penn’orth; perhaps the KMA’s condemnation of the pill is actually a good thing, albeit for the wrong reasons? I say this because the pill is great when two people are having a mutually exclusive sexual relationship – but in Korea, where so many men access commercial sex services, perhaps sticking to condoms is a better idea? I don’t think this is a consideration the KMA had in mind, of course. Just a thought.

    • Well, yes and no. Just in case you haven’t read this, this, this, and this post on the subject, the vast majority of Korean women believe contraception is entirely men’s responsbility, so challenging that attitude and also instilling a “no (condom) means no” concensus among them – in other words, making them more proactive, confident and involved in their sexuality – would be a far more effective method of preventing unwanted pregnancies and STDS than scare-mongering about a perfectly safe and acceptable contraceptive method.

  9. omg, this is kind of true..so I asked my neighbor friend about the pill and what she thinks… she’s 21 (korean age..so 19/20 american age) and has had sex but she’s never used the pill as a form of contraception mainly because she’s afraid of getting fat. she says, “I don’t like fat and I don’t want bad blood” <–what does that even mean? bad blood?! She just said that her mother said it wasn't good for health, so I told her that I've taken it before to help regulate my period..etc and she goes.."maybe that's why you little bit not thin?" LOL.

    • Like you say, OMG, but unfortunately I’m not surprised. To my wife’s credit, all the horror stories seemed to completely bypass her, although for unspecified reasons she did originally think the pill was only really appropriate for engaged couples. Glad to say that she didn’t stick to that phase for very long(!), but I do have a good friend and his Japanese girlfriend of 3 years in Japan who use the withdrawal method rather than condoms or the pill etc., which I’m frankly amazed that any educated, monogomous couple would continue using for very long. Testifies to the strength of the horror stories in Japan I guess, as it’s entirely her choice and she refuses to even consider the possibility that there are alternative opinions to the pill.

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