The Birth Control Pill: Is It Right For You?
The pill. Love it or hate it, most sexually active women have tried it. And if you’re taking it, you should know all you can about it, because knowledge is power. That’s why we’re going to give you a rundown on what it is, how it came about and possible pros and cons.
What is the pill?
The birth control pill actually comes in a few different forms, the most common of which is known as “the pill.” This version is a combination of synthetic estrogen and progestin.
The combo pill suppresses ovulation, changes cervical mucus to make it hard for sperm to reach the egg, and changes the lining of the uterus to make it more difficult for an egg to implant.
The “mini-pill” or progestin-only pills change cervical mucus and uterine lining. They may also suppress ovulation but not always.
How long has it been around?
In terms of contraceptives, both forms of the pill are relatively new inventions. Progestin wasn’t synthesized until the early 1930s, but years of testing and tweaking had to happen before it became available to women as a contraceptive.
In the 1950s, scientists performed the first trials on women and found that synthetic hormones could prevent pregnancy. There were some serious side effects, however, like blood clots, heart attacks, and stroke among the most major.
In 1957, the pill received FDA approval, but only to control menstruation, not as a contraceptive. It wasn’t until 1960 that it received FDA approval for contraception. Cultural norms, however, made the idea of contraception taboo, even for married women. Five years later in 1965, a Supreme Court case cleared up the legality of the pill and okayed it as a contraceptive for married women. And it wasn’t until 1972 that the Supreme Court legalized it for all women, married or not.
At the time the pill was in court getting legalized, it was also receiving negative publicity for dangerous side effects. Male-dominated senate hearings were interrupted by feminists who wanted a voice in a topic that concerned them more than it did the men making the rules. Their voice resulted in the doses of hormones in all forms of the pill being dropped to much smaller levels while still maintaining the pill’s efficacy. From the 1980s on, the pill has remained much the same, with small changes and tweaks here and there.
For starters, the pill revolutionized how women live. Before hormonal birth control, a woman most often could expect to go to school (college if she was lucky), meet her dream partner, and settle down for a few decades of childbearing..
With the pill, women could choose if and when they wanted to have children. This choice allowed them to enter the workforce and change the world for the better.
The birth control pill is effective with studies showing that it’s 99% effective in perfect use and 91% effective in typical use. It has also been shown in some studies to lower risks for certain kinds of cancer although the research is conflicting on this topic.
The pill can also help regulate difficult periods, so depending on how uncomfortable you are during menstruation, it is an option to discuss with your doctor.
While the dosages of hormones in both the combo pill and the mini pill have been drastically reduced, many women are still very sensitive to even small amounts of hormones, so they can experience headaches, mood swings, irritability, bloating, and weight gain. The combination pill still carries a risk of heart attack, blood clotting, and stroke, so women at risk of heart disease should not take an estrogen-containing birth control pill.
Breastfeeding moms should also not take the combination pill, but can safely take the mini pill.
And then there’s the issue of remembering to take it. Women on the combination pill have a little more flexibility for when they take the pill, but women on the mini-pill must take it at the same time every day. Missing a pill or forgetting to take it at the right time increases your risk for an unplanned pregnancy. Again, while it’s 99% effective if taken correctly, it’s been shown to be about 91% effective in typical use - with most failures due to forgetting to take the pill consistently at the same time each day.
Is it right for me?
This is where you need to have a serious chat with your physician. Some questions to ask yourself are:
What’s my medical history?
Am I at a higher risk for heart disease, blood clots, or stroke based on my or my family’s history?
Am I breastfeeding?
Am I comfortable with the potential side effects?
Will I remember to take it (there are apps out there that help you remember when to take your pill)?
Once you’ve discussed those answers with your physician, you’ll be able to make a well-informed decision for your reproductive health.
What type of contraception do you use?
This is the first in a multi-part series looking at different types of contraception, how they work and what to consider before choosing that particular method.
Petitti, Diana. "Four Decades of research on Hormonal Contraception." The Permanente Journal/9, no. 1 (2005). doi:10.7812/tpp/04-129.
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