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The Pill

Posted May 28 2011 2:32am

Record numbers of women are taking “the pill.”  The National Center for Health Statistics reported last year that 82% of adult American women have taken “the pill” at some point in their lives.  Between 2006-2008, it is believed that 10.7 million women used “the pill.”  So let’s spend a little time getting to know more about the pill that’s so common it needs no other name.

Throughout the beginning of the twentieth century, scientists were exploring the human body with more and more sophisticated tools.  This research included hormones and, by the 1930s , science understood how hormones worked and discovered that in certain doses estrogen, progesterone, and androgen (types of hormones) stopped an egg from being released by the ovaries (a process called ovulation).  The process of manufacturing these hormones, though, was expensive.  By the mid 1940s, the process had been streamlined and the price of these synthetic hormones plummeted.  Little interest was shown right away in developing these hormones into pharmaceuticals for distribution as contraceptives.

Research began to pick up again in the 1950s, and by June 1957 the earliest version of “the pill” was approved by the Food and Drug Administration (FDA) in the United States.  However, this pill, called Enovid , was only meant to help regulate menstrual problems.  (In fact, “the pill” is frequently still prescribed for menstrual irregularities.)  It was not until three years later that the FDA approved Enovid for use as a contraceptive.  In 1965, a court case made it legal for all married women to obtain a prescription for “the pill” and in 1972 another court case made it legal for all women in the United States to be prescribed “the pill.”

Today, “the pill” still operates along the same principles as its forerunners.  The technical name for “the pill” is the combined oral contraceptive pill.  In other words, they are pills taken by mouth to help prevent pregnancy by using different types of hormones.  The usual course of pills is 28 days long with 21 days of active pills (containing hormones) followed by 7 days of inactive pills (placebos–also called sugar pills) during which time a woman has her period.  Some types of “the pill” have shorter or longer courses than 28 days.  The hormones used in the active pills disrupt the ovulation cycle, thus preventing the ovaries from releasing an egg.

Effectiveness of “the pill” in preventing pregnancy is extremely high (over 99%) when used perfectly.  However, most people mess up from time to time, thus lowering the effectiveness to about 91%.  Certain things can even more greatly reduce the effectiveness of oral contraceptives, including using antibiotics and St. John’s wort.  It is always best to use another type of contraceptive, such as a condom, in conjunction with “the pill” to maximize effectiveness.  It is especially important to use a condom with “the pill” in order to prevent the spread of sexually transmitted diseases.

Side effects of “the pill” vary between different formulations of it.  Some common side effects include headaches, breakthrough bleeding (or “spotting”) in the middle of the cycle, increased risk for blood clots, and reduced pain during menstruation.  There are innumerable formulations of “the pill,” with differences in the amount and types of hormones used, and each will act differently.  So it is important to discuss with your doctor the side effects of the formulation he or she suggests.  If you try one formulation but don’t like it, do not despair–another formulation may be just what you are looking for.

There are other types of contraceptive pills, most notably “the day after pill.”  This is a form of emergency contraception and should not be used on a regular basis as one would use “the pill.”  Regular contraceptive pills are the most common form of birth control in the United States , though they are not for every one.  Be sure to consult your doctor about other forms of contraception (such as IUDs, “the patch,” diaphragms, “the ring,” and implants).

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