Happy birthday to you, oral contraception. Fifty years ago, the FDA approved the first hormonal method of birth control; it would change American society forever, allowing women to pursue higher education and join the workforce in record numbers. Oral contraception has enough of a following to pull off the nickname “The Pill.”
The Pill has aged gracefully, becoming so common in the US that the phrase “birth control” is often understood to mean oral contraceptives. There have been some universal improvements. For example, all dosages are much lower today, which means fewer side effects and no long-term effects.
However, several features of The Pill that were decided on by the men developing the drug in the 1950s remain in most oral contraceptives today.
For example, Pill packs always start on a Sunday. Why? Not because it’s the beginning of the calendar week, but because if a wife starts on Sunday, she won’t have her period on the weekends when her husband is home.
Another hold-over from the 50s is the 21 active pills/7 placebo pills regimen. What’s wrong with 21/7? Nothing, if a woman wants to bleed every month and is great at remembering to take a pill every day.
The Pill was revolutionary for its time in using hormones to modify bodily processes, namely ovulation. The makers of The Pill wanted women (and men) to see as little change in what was considered “normal” as possible. With the 21/7 combo, a woman experiences a “withdrawal bleed,” similar to menstruation, every month.
There is no medical reason why women on The Pill need to have a withdrawal bleed every month.
Having fewer days a year off active pills also reduces the risk of going more than seven days in a row off hormones, which can lead to ovulation and possible pregnancy. New extended-cycle pills make having fewer or no “periods” easy. Most pills can be taken without their placebo weeks; check with a health provider or pharmacist. Some pills now use a 24/4 combo, which also reduces the chance of going more than seven days off hormones.
What if a woman isn’t good at remembering things? The Pill was designed for housewives in the 1950s, not busy college students with different schedules every day. Luckily, there are other methods that require a lot less work than The Pill.
In 2001, the FDA approved two new methods of birth control, the patch and the vaginal ring. They contain the same hormones as The Pill, but they are delivered in a different way. The Patch is changed once a week and the Ring once a month.
There are also effective methods that contain fewer or no hormones: intrauterine devices, or IUDs.
IUDs require no work once they are inserted by a health professional and last for five or 10 years, depending on the type. IUDs are more effective than The Pill and there is no user error. Plus, they are totally reversible when a woman decides she wants to get pregnant.
They can be used by almost all women, even if they have never been pregnant, and do not increase the risk of infertility.
Want to learn more about The Pill or different options for contraception? Come talk to a counselor at Campus Health Services for free or check out Campus Health’s Web site.
Laura Glish, UNC ‘09, is currently working as a sexual health educator. Contact her at: laura.glish@gmail.com
