Although most people assume that oral contraception was invented in the 1960s, the practice dates back thousands of years. Some ancient civilizations created drinkable potions of plants and tree bark. According to some reports, extract from the silphium plant was so effective in preventing pregnancy that the plant was used to extinction over fifteen hundred years ago![1]
In the Middle Ages new concoctions were invented, some of which proved to be fatal for the women, who didn’t realize the drawbacks of drinking mercury, lead, arsenic, and strychnine. Even when women did not ingest the medicine, they were often subjected to bizarre practices. Some civilizations urged women to wear amulets that contained the liver of a cat or the earwax of a mule![2] Over time, advances in medical technology replaced such superstitious and ineffective methods.
In the early 1900s, scientists began to experiment with the fertility of animals by using orally administered hormones. Some methods proved to be effective, but mass-producing enough hormones for human use seemed impractical. Scientists required gallons of urine or thousands of pounds of organs in order to extract a few milligrams of sex steroids.[3]
When a chemist in the 1940s was able to produce hormones from certain plants, researchers no longer needed the ovaries from more than two thousand pregnant pigs to create one milligram of progesterone. With only five gallons of liquefied roots of Mexican yams, he could create three kilograms of hormone. With continued progress in the development of synthetic hormones, oral contraception became a reality.
In 1950 Planned Parenthood invited an American biologist named Gregory Pincus to create an “ideal” and “harmless” form of birth control. As it usually does, research began on animals, such as rabbits and mice. Within a few short years, social workers in Puerto Rico were handing out oral tablets to women throughout the barrio. One witness recalls, “Women were told this was medicine that would keep them from having children they couldn’t support.”[4] What these women did not know was that they were being used as test subjects. During these clinical trials, three women died of complications that arose from taking the drug. As a result, the researchers changed the dosage and continued testing.[5]
Further studies were conducted in the United States and abroad, and the FDA approved the birth control pill for contraceptive use in 1960. It didn’t take long before safety concerns began to crop up, including the Pill’s tendency to increase a woman’s risk of suffering heart attacks and strokes. By 1970, the FDA initiated efforts to give information about the drug to the women who used it. As scientists learned more about the harmful chemicals in the Pill, they sought to experiment with different levels and types of hormones.
Over time the chemicals in the Pill have changed considerably. For example, when the Pill was first approved, it contained five times as much estrogen as some of today’s birth control pills.[6] Estrogen enhances clotting of the blood, and so the higher dosage of the hormone led to many injuries related to blood clots, such as strokes and heart attacks.
Because such levels of hormones were dangerous and unnecessary for women, the FDA told doctors in 1970 to prescribe the lowest possible dose of estrogen available at the time. Sales of the higher-dose pills began to drop. In 1973 those in the population control business saw the opportunity to obtain the high-dose pills at a low cost and spent millions of dollars buying up the leftover stock for shipment overseas for use by women in developing nations, despite the safety concerns.[7]
In order to prevent pregnancy, birth control pills employ several mechanisms. First, the synthetic hormones may convince a woman’s body that she is pregnant. This can stop the ovaries from releasing an egg. The Pill also makes it difficult for the sperm to reach the egg, because the hormones thicken the cervical mucus. Normally, on the days of each month when a woman is fertile, her cervical mucus has microscopic channels in it that make it easier for the sperm to travel to the egg. The mucus also nourishes the sperm, allowing them to live longer. However, when a woman is infertile (which is true for the greater part of each month) her cervical mucus changes. It looks more like a mesh or net at the microscopic level. The Pill causes the woman’s body to produce this type of cervical mucus on a continual basis, thus making it difficult for the sperm to live and move.
The Pill also creates changes in the uterus and fallopian tubes that can interfere with the transport of sperm.[8] Despite the hormones’ ability to prevent the release of eggs, sometimes a “breakthrough ovulation” takes place. How often this happens depends upon several factors, such as which kind of pill the woman is taking, how consistently she takes her pills, and even how much she weighs. Even with correct and consistent use of the Pill, some formulas allow ovulation in less than 2 percent of cycles, while others allow a woman to ovulate during 65 percent of her cycles.[9]
When a woman ovulates, she can become pregnant. However, the Pill has mechanisms that can cause an abortion before a woman knows that she has conceived. If a sperm does fertilize the egg, the newly conceived baby (zygote) may be transported more slowly through the fallopian tubes because of how they have been altered by the Pill. Thus, the child may not reach the uterus, where he or she needs to implant and receive nourishment for the next nine months. Because the fallopian tubes are changed, the baby may accidentally implant there, causing an ectopic or “tubal” pregnancy, which is fatal to the baby, and can also be life-threatening for the mother.
If the baby is able to travel safely to the uterus, he or she may not be well received. One reason for this is that the chemicals in the Pill thin out the lining of the woman’s uterus (the endometrium).[10] As a result, the baby may not be able to implant. At other times the child will attach to the wall, but he or she will be unable to survive because the normally thick and healthy uterine wall has shriveled and is therefore unable to nourish the baby. The Pill also impacts the woman’s progesterone level. This causes the lining of the uterus to break down and eventually shed as it would in a menstrual cycle, further denying the baby’s attempt to implant.
Many doctors are concerned about the fact that women often are not informed that the birth control pill can cause an abortion as well as prevent pregnancy. One medical journal declared, “If any mechanism of any OC [Oral Contraceptive] violates the morals of any particular woman, the failure of the physician or care provider to disclose this information would effectively eliminate the likelihood that the woman’s consent was truly informed and would seriously jeopardize her autonomy. Furthermore, there is
a potential for negative psychological impact on women who believe human life begins at fertilization, who have not been given informed consent about OCs, and who later learn of the potential for postfertilization effects of OCs. The responses to this could include disappointment, anger, guilt, sadness, rage, depression, or a sense of having been violated by the provider.”[11]
Unfortunately, not all doctors are aware that the Pill can act as an abortifacient. Dr. Walter Larimore admitted that he prescribed the Pill for nearly twenty years—and used it in his own marriage before anyone informed him that it could have such an effect.
When another doctor clued him in, he said that he had never heard of such a thing, and that the claims seemed to be “outlandish, excessive, and inaccurate.”[12] He began a search of the medical literature, “to disprove these claims to my partner, myself, and any patients who might ask about it.” However, what he discovered compelled him to stop using the Pill in his medical and personal life. Reviewing the information, he realized how many doctors (and patients) were ignorant of the abortifacient potential of the Pill. It was a humbling realization, considering that ever since the 1970s, the patient package insert for birth control pills explained how the drug reduces the likelihood of implantation.[13]
After informing his colleagues, Dr. Larimore noted, “several said that they thought it would change the way family physicians informed their patients about the Pill and its potential effects.”[14] Because many physicians felt that it was unfair to leave women in the dark, some of them submitted a proposal to the American Medical Association (AMA) calling for a vote on whether doctors should tell patients that birth control pills can act as abortifacients. However, in 2001 the AMA voted overwhelmingly against the proposal.
One reason why certain doctors may not tell women about the abortifacient nature of the Pill is that some physicians do not believe that pregnancy begins with fertilization. Until the 1960s, when the Pill was invented, it had been taken for granted that the union of the sperm and egg signaled the beginning of pregnancy. In 1963 even the United States government published health information declaring that anything that impairs life between the moment of fertilization and the completion of labor is to be considered an abortion.[15]
Because many women would never have agreed to use a drug or device that could cause an early abortion, those in favor of such contraceptives knew that the issue had to be resolved. In 1964 a Planned Parenthood doctor speaking of another type of abortifacient birth control recommended that scientists not “disturb those people for whom this is a question of major importance.” He added that judges and theologians trust the medical community, and “if a medical consensus develops and is maintained that pregnancy, and therefore life, begins at implantation, eventually our brethren from the other faculties will listen.”[16]
One year later the American College of Obstetricians and Gynecologists (ACOG) decided to redefine pregnancy. In its words, “conception is the implantation of a fertilized ovum.”[17] Instead of defining conception as fertilization, ACOG decided that life begins nearly a week later, at implantation. At the time they said that this was because pregnancy could not be detected before then. Today science is able to detect pregnancy before implantation, but the ACOG still won’t correct its definition.[18] The original change had nothing to do with a scientific discovery in women’s health, reproduction, or biology. Unfortunately, doctors today are split on the issue.[19]
Regardless of a doctor’s personal opinions, few women are ever informed about this issue. Feminist author Germaine Greer wrote, “Whether you feel that the creation and wastage of so many embryos is an important issue or not, you must see that the cynical deception of millions of women by selling abortifacients as if they were contraceptives is incompatible with the respect due to women as human beings.”[20]
Sometimes, all of the Pill’s mechanisms fail to prevent pregnancy and successful implantation. It is often said that with optimum use of the Pill, it should have an effectiveness rate of 99 percent. Therefore, it is said to have a “method” failure rate of about 1 percent. However, in typical use the rates change significantly. This can be caused by many things, such as a woman’s forgetting to take her pill or taking it at the wrong time of the day. Thus the actual rate, called the “typical” or “user” failure rate. For the first year of use for women under the age of twenty, the Pill has an annual failure rate of 8 to 13 percent.[21] One study that followed sexually active teenage girls on the Pill found that 20 percent of them became pregnant within six months![22]
The typical failure rate of the Pill has been shown to vary according to such factors as a woman’s age, race, marital status, education, and economic status. For example, one large study showed that poor teenage girls who lived with their boyfriends had a 48 percent chance of getting pregnant during their first year on the Pill, whereas a wealthy married woman over the age of thirty had a 3 percent chance of pregnancy.[23]
There are numerous health risks in taking the Pill, since it contains potent synthetic hormones. According to the drug information that is included in birth control pills, the user may experience the following side effects: heart attack, blood clot, stroke, liver cancer, breast cancer, gallbladder disease, headache, bleeding irregularities, ectopic pregnancy, weight gain, mental depression, yeast infection, changes to the curvature of the eye, excessive hair growth in unusual places, loss of scalp hair, acne, partial or complete loss of vision, and more.[24] Some of these adverse reactions are rare, and others are more common, depending upon the type of pill and the particular woman who takes it.
The risk of breast cancer is especially worrisome for young women, since twenty-one of twenty-three studies of women who took the Pill prior to having their first child showed an increased risk of breast cancer.[25] The increase was especially steep among younger women. The World Health Organization and even the companies that sell birth control pills also admit that the drug can increase a woman’s risk of breast cancer.[26]
The birth control pill also has been shown to increase a woman’s level of SHBG (sex hormone binding globulin), which decreases the amount of testosterone available in her body.[27] This is one reason birth control pills are sometimes prescribed to treat acne. A decrease in free testosterone in a woman’s body may decrease the severity of acne. However, when testosterone is decreased, so is the woman’s sex drive.
It used to be thought that this undesirable side effect would be reversible. However, research published in The Journal of Sexual Medicine showed levels of SHBG twice as high as normal among women a year after they went off the Pill. The authors stated, “Long-term sexual, metabolic, and mental health consequences might result as a consequence of chronic SHBG elevation.”[28] In an article entitled “Can taking the pill dull a woman’s desire forever?” the same scientists feared, “There’s the possibility it is imprinting a woman for the rest of her life.”[29]
When women take the Pill for a long period of time, their risk of heart disease may be increased even after they go off the Pill. When this discovery was made, a cardiologist from Johns Hopkins University said, “What would I tell my daughter to do? I might suggest maybe not oral contraception.”[30]
Recent studies also suggest that if a woman becomes pregnant with a boy while taking the Pill, her son may be more likely to develop prostate cancer. This is because the synthetic hormones can deform the male prostate in developing baby boys. One researcher noted that the chemicals in the Pill are “extremely potent synthetic sex hormones, strong enough to completely control an adult woman’s reproductive system. . . . The developing fetus is extremely sensitive to chemical disturbance . . . so exposing a male baby to them is a very bad idea.”[31] Considering the failure rate of the pill and the number of women taking it worldwide, more than one million boys may be affected each year. Since this discovery is new, further research will need to be conducted in order to confirm and measure this risk.
Other studies suggest that the birth control pill can affect who you’re attracted to. Here’s what some scientists are saying: Many animal species have pheromones, which are odorless chemicals that can signal their availability, arousal, or sexual receptivity. This chemical can be detected by what’s called the vomeronasal organ (VMO), located in the nose. You may have heard that when women live together in close proximity, their menstrual cycles often begin to synchronize. Some have theorized that pheromones may play a role in this, because they can have an effect on hormones.
In animal studies, researchers have discovered that pheromones also play a role in mate selection. For example, a female mouse tends to choose a mate that has MHC genes that are least like her own. MHC (major histocompatibility complex) is a segment of our DNA that plays a role in the immune system, and it can be detected through pheromones in mice. By selecting a mate with the MHC genes most different from her own, the offspring of the mouse is given a greater variety of MHC molecules, thus strengthening its immune system and increasing its odds of survival. It’s one of nature’s ways of ensuring offspring with superior immune systems.
Because of these interesting findings, scientists have set out to determine if a similar mechanism is at work in human mate selection. Preliminary findings based on a woman’s preference of a man’s scent show that women also prefer mates who have MHC genes that are least similar to their own.[32] How does this all relate to the birth control pill? Women on the Pill have been shown to prefer the scent of men whose MHC genes are most similar to their own. So if a woman on the Pill mates with a man who has similar MHC genes, their offspring may have an inferior immune system. The explanation given for the change in the woman’s preferences is that the Pill causes a woman’s body to think that it is pregnant, and pregnant women tend to prefer the scents of family and relatives. Some women even reported that they felt less attracted to the men they were seeing after going off the Pill. Other researchers have proposed that because a woman’s fertility is interrupted when she is on the Pill, it alters her own pheromones. This, in turn, makes her less desirable to men, or so the theory goes.[33] While such research is interesting, it is still widely debated.
According to the Textbook of Contraceptive Practice, the Pill causes more than 150 biological changes in a woman.[34] Some of these changes are drastic, and others are hardly noticeable. For example, one study showed that women using oral contraceptives blink 32 percent more often than nonusers.[35] The reason for this may be that the chemicals in the Pill can decrease the hydration of the woman’s eye. The Pill also can cause a slight change in the shape of her eyeball, making the cornea steeper. These side effects could explain why women on the birth control pill often complain that their contact lenses have become uncomfortable.
Undoubtedly science has not fully grasped the many ways in which birth control pills interfere with a woman’s delicate and majestic physiology. Despite the possible side effects, birth control pills remain the most popular form of contraception for American women.[36] In turn, they have become a lucrative business. For example, one popular pill called Ortho Tri-Cyclen registered $715 million in sales in 2003.[37] Considering that it is only one of dozens of brands available, you can imagine the immense profits being made.
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[1]. Baylor College of Medicine, “Evolution and Revolution: The Past, Present, and Future of Contraception,” The Contraception Report 10:6 (February 2000), 15.
[2]. Baylor, “Evolution and Revolution,” 16.
[3]. Baylor, "Evolution and Revolution,” 19.
[4]. Ray Quintanilla, Puerto Rico Herald, “Anger At Island’s ‘Pill’ Test Lingers,” Orlando Sentinel, April 5, 2004.
[5]. Janet E. Smith. "Contraception, Why Not." Audiotape of lecture presented at meeting of the Catholic Physicians Guild at the Pontifical College Josephinum, Columbus, Ohio, May 1994. (Dayton, Ohio: One More Soul, 1999).
[6]. Department of Public Health & Policy, London School of Hygiene & Tropical Medicine, “The Pill: Balancing the Risks and Benefits,” Research Briefing 1 (May 2000), 1; Aude Lagorce, “Schering AG Storms Birth Control Market,” Forbes.com (July 11, 2003).
[7]. Barbara Ehrenreich, “The Charge: Genocide,” Mother Jones (November/ December 1979).
[8]. Walter L. Larimore and Joseph B. Stanford, “Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent,” Archives of Family Medicine 9 (February 2000), 127.
[9]. Larimore and Stanford, 127.
[10]. Physicians’ Desk Reference (Montvale, N.J.: Thomson, 2006), 2414.
[11]. Larimore and Stanford, 131.
[12]. Larimore and Stanford, 133.
[13]. Federal Register 41:236 (December 7, 1976), 53,634.
[14]. Larimore and Stanford, 133.
[15]. Public Health Service Leaflet no. 1066, U.S. Dept. of Health, Education, and Welfare (1963), 27.
[16]. Sheldon Segal, ed., et al., “Proceedings of the Second International Conference, Intra-Uterine Contraception,” October 2–3, 1964, New York City, International Series, Excerpta Medica Foundation, No. 1 (September 1965).
[17]. College of Obstetricians and Gynecologists, “Terms Used in Reference to the Fetus,” Terminology Bulletin 1 (Philadelphia: Davis, September 1965).
[18]. Shu-Juan Cheng, et al., “Early Pregnancy Factor in Cervical Mucus of Pregnant Women,” American Journal of Reproductive Immunology 51:2 (February 2004), 102–105.
[19]. J.A. Spinato, “Informed Consent and the Redefining of Conception:
A Decision Ill-Conceived?” The Journal of Maternal-Fetal Medicine 7:6 (November-December 1998), 264–268.
[20]. Germaine Greer, The Whole Woman (New York: Anchor Books, 1999), 99.
[21]. Haishan Fu, et al., “Contraceptive Failure Rates: New Estimates From the 1995 National Survey of Family Growth,” Family Planning Perspectives 31:2 (March/April 1999), 61.
[22]. L.M. Dinerman, et al., “Outcomes of Adolescents Using Levonorgestrel Implants vs Oral Contraceptives or Other Contraceptive Methods,” Archives of Pediatrics & Adolescent Medicine 149:9 (September 1995), 967–972.
[23]. Haishan Fu, et al., 61.
[24]. Physicians’ Desk Reference, 2416–2417.
[25]. Chris Kahlenborn, et al., “Oral Contraceptive Use as a Risk Factor for Premenopausal Breast Cancer: A Meta-Analysis,” Mayo Clinic Proceedings 81:10 (October 2006), 1290–1302.
[26]. World Health Organization, “IARC Monographs Programme Finds Combined Estrogen-Progestogen Contraceptives and Menopausal Therapy are Carcinogenic to Humans,” International Agency for Research on Cancer, Press Release 167 (July 29, 2005); Physicians’ Desk Reference, 2415.
[27]. Physicians’ Desk Reference, 2414; Julia Warnock, et al., “Comparison of Androgens in Women with Hypoactive Sexual Desire Disorder: Those on Combined Oral Contraceptives (COCs) vs. Those Not on COCs,” The Journal of Sexual Medicine 3:5 (September 2006), 878–882.
[28]. Panzer, et al., “Impact of Oral Contraceptives on Sex Hormone-Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction,” Journal of Sexual Medicine 3:1 (January 2006), 104–113.
[29]. “Can Taking the Pill Dull a Woman’s Desire Forever?” New Scientist (May 27, 2005), 17.
[30]. “Study Links Birth Control Pill to Arterial Plaque,” Reuters (November 6, 2007).
[31]. John Pickrell, “Oral Contraception Linked to Prostate Deformities,” New Scientist (May 2005); Barry Timms, et al., “Estrogenic Chemicals in Plastic and Oral Contraceptives Disrupt Development of the Fetal Mouse Prostate and Urethra,” Proceedings of the National Academy of Sciences 102:19 (May 10, 2005), 7014–7019.
[32]. F. Bryant Furlow, et al., “The Smell of Love: How Women Rate the Sexiness and Pleasantness of a Man’s Body Odor Hinges on How Much of Their Genetic Profile is Shared,” Psychology Today 29:2 (March/April 1996), 38; Sarah Richardson, “Scent of a Man,” Discover 17:2 (1996), 26.
[33]. Lionel Tiger, The Decline of Males (New York: St. Martin’s Griffin, 1999).
[34]. Malcolm Potts and Peter Diggory, Textbook of Contraceptive Practice, 2nd ed. (Cambridge: Cambridge University Press, 1983), 155.
[35]. D. P. Yolton, et al., “The Effects of Gender and Birth Control Pills on Spontaneous Blink Rates,” Journal of the American Optometric Association 65:11 (November 1994), 763–770.
[36]. William Mosher, et al., “Use of Contraception and Use of Family Planning Services in the United States, 1982–2002,” Advance Data From Vital and Health Statistics 350, Centers for Disease Control (December 10, 2004). 1.
[37]. Suzanne Shelley, “Authorized Generics’ Makes for Surprising—and Controversial—Partnerships,” Pharmaceutical Commerce (January 1, 2006).