Making sex and childbearing more free: a brief history of oral contraceptives

Since the birth control pill appeared on the market nearly 60 years ago, it has become the first choice of birth control for millions of women around the world Nowadays, the wide use of the drug makes it easy to forget that its development represents a revolutionary change in family planning and women's reproductive rights Prior to the development of contraceptives, the choice of contraceptives was extremely limited, which usually required the cooperation of male partners, and was illegal in many countries In 1916, Margaret Sanger, who was about to establish the Planned Parenthood Association, put forward a vision of a new form of contraception: a way that can be taken orally, does not hinder sexual intercourse, and does not affect future fertility Sanger's motivation for the drug stems from her own experience as a nurse in New York's slums There, she witnessed women suffering from repeated pregnancies, childbirth and illegal abortions Photo source: shutterstock.com although most women are as eager for better contraceptives as Sanger, contraceptive development is slow With so many scientific, social, political and legal hurdles to overcome, the pill did not come true until 50 years after her vision The scientific development of women's fertility depends on the maturation and release of eggs in the ovary This process is regulated by a hormone feedback loop involving the ovaries, brain and pituitary gland Oral contraceptives work by interfering with this feedback loop and inhibiting egg production It also makes the cervix produce a thick layer of mucus to block sperm movement In fact, the practice of contraception by manipulating this feedback loop can be traced back to the invention of contraceptives Some traditional drugs contain such substances, which can work in the same way as birth control pills However, it was not until the 1930s that there was sufficient evidence that progesterone injection inhibited fertility in rabbits Progesterone is a hormone produced by the ovaries during the menstrual cycle Although these early experiments are effective, they are very inefficient The only source of progesterone is animal ovarian tissue, which requires thousands of ovaries to produce several milligrams of progesterone This problem was solved in the early 1940s At that time, a method was developed to extract a large amount of progesterone from a wild yam native to Mexico The new form of progesterone also has a big advantage: it can be administered orally without injection Another advantage of yam extract is that it also contains a small amount of ethinylestradiol methyl ether, an estrogen Previous studies have shown that estrogen can reduce the common side effect of progesterone in the treatment of penetrating hemorrhage All the elements needed for birth control pills are in place But before Sanger's "magic drug" came on the market, it needed to be tested in women Due to the difficulty in recruiting enough women to participate in human clinical trials, and the high rate of off trial due to side effects, the preliminary trial plan for contraceptives is very short in the United States After that, trials of contraceptives moved to Puerto Rico There, hundreds of women took part in the experiment The women were not informed that they were participating in the trial or received information about the risks they might pose It's a black history of birth control pills During the trial, two women died and nearly 20% reported side effects such as headaches, weight gain, nausea and dizziness These side effects are caused by very high levels of hormones in the drug Some women also experience long-lasting health problems as a result of the treatment Despite the large number of side effects, only one of the women in Puerto Rico was pregnant, so the trial was considered successful The drug was approved in 1957 to treat "menstrual disorders" in the United States, and finally became a contraceptive in 1960 In 1961, it was approved in Australia, New Zealand and the UK Although the release of the drug was opposed by Catholic Church and even some feminists, the general response of the public was very positive Women celebrate the new birth control method Contraceptives are even related to the improvement of women's education and social status This new freedom comes at a cost: side effects are common, and some women experience even more severe syndromes, such as stroke, heart disease, thrombosis, depression In the 1969 book the doctors' case against the hill, Barbara seaman reveals these risks This led to the 1970 directive that all drugs must contain patient safety information In 1988, large doses of contraceptives were finally put on the market They have been replaced by new low-dose formulations with better safety and fewer side effects Now, more than a century has passed since Margaret Sanger proposed the seemingly inconceivable safe and effective oral contraceptive program Oral contraceptives remain the mainstay of hormone based contraceptives However, it is not the only choice The research in this field is developing rapidly What progress will happen in the next 100 years? Let's see Reference: concept: past, present and future fact sheet "The pill" and its four major developers Proc (bayl Univ Med cent) 2015 Jul; 28 (3): 421 – 432 Understanding your cultural cycle fact sheet Concept – the pill - better health channel poroporo plant - concept and regulation the Evolution of Drug Discovery： From Traditional Medicines to Modern Drugs By Enrique Ravina.Dr Henning Steinhagen.https://doi.org/10.1002/cmdc.201100321   Russell Marker and the Mexican Steroid Hormone Industry History of oral contraception Marc Dhont The European Journal of Contraception & Reproductive Health Care， 15：sup2， S12-S18， DOI： 10.3109/13625187.2010.513071  The Birth Control Pill - A History  Inclusion of Latino Women in Clinical and Research Studies: Scientific Suggestions for Assuring Legal and Ethical Integrity Ruth E Zambrana.Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies: Volume 2: Workshop and Commissioned Papers The contraceptive pill was a revolution for women and men Freer sex and family planning—a short history of the contraceptive pill