The Birth of Birth Control Pill


by Dr. S. Y. Chong

The earliest evidence of contraceptives is said to be noted in the 4000-year old Kahun Papyrus from Northern Egypt. As incredible as it sounds today, it recommends a mixture of rubber, honey, soda, and rock salt, with a paste of crocodile dung and sour milk to be inserted into the vagina prior to sexual intercourse. Then there were the those in the Middle Ages who used 'condoms' made from animal gut or fish skin, though these were considerably less effective than the latex condoms we have today.





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Did you know that 'The Pill' was invented by a woman? And this year marks the 50th anniversary of the birth of the birth control pill. The development of the birth control pill, which we now also refer to as 'The Pill' or 'oral contraceptive' (OC) would not have been possible without two women : Margaret Sanger and Katherine McCormick.


The Inventor

Margaret Sanger, a nurse and a strong advocate of women's rights, was convinced that a contraceptive controlled by the woman herself was the viable solution to free women from too many unplanned pregnancies. She convinced Katherine McCormick, a millionairess and philanthropist, who was also the first female science graduate from the Massachusetts Institute of Technology, to support her cause of developing the pill.

In this era of blogs and public confessions, it is hard to believe that the dissemination of contraceptives or information about them was illegal in the United States in the first half of the 20th century. This meant that advocates of the birth control pill had to overcome not only important scientific hurdles, but also widely held cultural and religious objections.


Both Sanger and McCormick, together with Dr Gregory Pincus, worked to develop the pill and introduced it to the American public in 1960. A year later, a similar pill for painful periods, which also had contraceptive properties, became available in Europe. These two amazing medical discoveries marked the start of the sexual revolution and women's liberation in the Western world.

Benefit

But from the viewpoint of economists and scientists, the pill was also an important way to defuse the population explosion and eliminate hunger, want, and ignorance in a world of shrinking natural resources.

One of the benefits of modern contraception is that it has promoted the concept of birth control as a fundamental right of women with regard to equality between men and women. This mindset led to further rights for women, in particular, their approach to procreation and, in more general terms, their way of life and their legitimate place in society.


Family Planning

In modern times, it is surprising that up to 50% of pregnancies worldwide are unplanned. Thus the importance of family planning cannot be overstated. Contraception allows women to plan their families. Family planning allows women to shape their lives according to their hopes and dreams, to have the options of education and a career first and having a family later.

Motherhood is an enriching experience. But it is also a life experience that can have far reaching negative consequences if it is entered into when a woman and her partner are ill prepared. Ideally, a woman and her partner should be emotionally, physically, and financially prepared for this important phase in their lives. The goal of family planning is to ensure that babies are conceived by choice, and not by chance.

The Ingredients

Every combined contraceptive pill contains 2 hormones, oestrogen and progesterone. The early scientific challenges in developing the pill involved identifying the chemical composition of these hormones and producing them artificially. The oestrogen component inhibits ovulation (release of ovum [egg] into the fallopian tubes and uterus) whilst the progesterone component causes the cervical mucous to become very thick and act as a barrier to sperm.

Currently, the synthetic oestrogen component in all pills is ethinyl estradiol whilst several types of progestogens (artificial progesterone) have been developed and improved upon over the years. Initially, the doses of ethinyl oestrogen were quite high, leading to side effects such as water retention and breast tenderness. It was the early pill that perpetrated the belief that combined contraceptives led to weight gain.

With scientific advances, pills with lower doses of ethinyl oestradiol that still offer effective contraception have emerged. From an initial dose of almost 50 mcg when first introduced in 1960, most modern pills today contain between 20 and 35 mcg of ethinyl estradiol. It is the progestogen component of the pill that differentiates one pill from another, and it is this progestogen component that has now evolved to offer benefits beyond contraception.

Cancer

It is well established that oral contraceptive pills offer protection from ovarian and uterine cancer. The newer generation of progestogens have even more benefits, one of which is to counteract the water retention caused by ethinyl estradiol to reduce weight gain and breast tenderness. Another is that these newer progestogens have also been clinically proven to improve mild to moderate acne and treat emotional symptoms of premenstrual syndrome (PMS) such as mood swings and anxiety.

Alternative dosing regimens for the combined oral contraceptive pills have also been studied. The most common dosing regimen is the 21/7 regimen, where pills are taken for 21 days with seven-day pill free period during which bleeding occurs. This mimics the natural 28-day menstrual cycle. There is now a new pill that has introduced a 24/4 regimen with 24 active pills followed by a 4-day hormone free interval, which prolongs the contraceptive effect as well as offers added benefits such as improvement in moderate acne and emotional symptoms of PMS.


Reversible

The oral contraceptive is a reversible method of contraception that can be stopped at any time the woman is ready to conceive. Most women who stop taking the pill generally revert to their normal menstrual cycle within 3 months. There is no evidence that short to mid-term use of today's pills adversely affects fertility. However, factors such as increasing age and the state of a woman's physical and mental health does affect fertility.

See Doctor First

Women who intend to start taking the oral contraceptive pill should see their doctor for a full medical examination so that an appropriate pill is prescribed to them. Whilst the pill has a well-established safety record, certain women with risk factors such as smoking, high blood pressure or family history of stroke may require pills with the lowest dose of ethinyl estradiol and need to be monitored closely, particularly for the first 6 months of use.


The pill's effect has been so profound that young women around the world today grow up knowing they are not limited by their biology. They see a broad landscape of opportunity that did not exist 2 generations earlier. The changing role and empowerment of women has had an impact throughout the whole societal infrastructure – not only as active contributors to innovation and the workforce, but also on the home front. The birth of the pill coupled with women's liberation movement on all fronts has made this possible.


More info on BIRTH CONTROL PILL here.






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