Saturday, May 8, 2010

Birth Control Pill Turns 50

The pill was originally approved by the FDA in 1957 for treatment of miscarriages and menstrual disorders. Three years later it was approved for birth control (1). Its landing was not quiet. Comstock (Victorian Style) laws passed in the 1870s still had residual effects. The head of a Planned Parenthood, Griswold, was arrested in New Haven, Connecticut just a few years after the pill's release. Her crime was giving out information to married couples on how to prevent pregnancies. The US Supreme Court decided 7-2 for Griswold under the right to privacy (2).

The pill has come a long way. The most salient observation to pill users is probably change in mood until a good match is found. Newer pills have lower levels of hormones than their ancestors. These lower levels have even observed reduced risk in certain cancers (pretty cool). Still, an elevated risk for heart attack is present among smokers, particularly those over 35. The incidence for smokers over 35 without using birth control is 88 per 100,000 per year. For oral contraception users in that demographic, the rate is 485 per 100,000 per yer.

Nonsmokers over 35 and smokers under 35 not using oral contraception have a risk of about 10 per 10,000 per year whereas their risk while using contraception jumps to roughly 40 per 10,000 per year (1). Many references use rates such as relative risk. But I think giving the actual numbers says more about the real risk, especially when they're low. Even the highest risk group here only has a risk of about .5% per yer compared to .1% not using the pill.

[Described Above] An interesting practice is using monophasic (same level of hormones) pills without taking the sugar pill breaks. This continuous use prevents menstruation and cramps (who wants those?). It is generally very rare to experience a pregnancy when no menstruation is taking place. For some, that news may not be enough. The anxiety of not having a period to know whether pregnancy has occurred may be rectified by using a pregnancy testing kit. Keep in mind, even having a period is no sure sign of having avoided a pregnancy (though obviously highly indicative). Some pills have been designed especially for continuous use. The most popular is probably Lybrel.

Above is a very simple description for how the pill works.


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