- The idea that taking hormones could prevent ovulation was first explored in the 1930s in an experiment with rabbits. Two decades later, women's rights advocate Margaret Sanger funded research into a birth control pill for women in the 1950s. Frank B. Colton developed Enovid, the first oral contraceptive. It was used "off-label" in the late 1950s, but not introduced to the market as a family planning method until 1960. The pill remained controversial in the 1960s, and was the subject of a legal ban in Connecticut that was struck down by the Supreme Court in 1965. That year, oral contraceptives became the most commonly used birth control method in the United States. Throughout the 1960s and 1970s, the formulation of birth control pills changed, and warnings came out about possible side effects. In 1970, the FDA ordered that all birth control pill packages contain a patient information insert detailing possible side effects. In the 1980s, pills containing very high doses of hormones were taken off the market, and pills containing lower dosages of hormones became the norm.
- Birth control contains hormones--chemicals a woman's body makes that control different parts of her body. Some birth control pills contain the hormone progestin only, but most contain two hormones: estrogen and progestin. These hormones work by preventing ovulation, meaning a woman's ovaries don't release eggs while she's taking the pill. The hormone progestin also thickens a woman's cervical mucus, and this works to block sperm from joining with an egg if one does get released.
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Most birth control pills on the market are "combined" pills, meaning they contain both estrogen and progestin. There's generally a larger window for error in taking the medication on time each day with combined pills. A small percentage of women use a progestin-only pill. These are sometimes referred to as the "mini-pill." Mini-pills have a slightly lower effectiveness rate over combined pills, and because they contain a lower dosage of hormones, they must be taken on time every day to prevent pregnancy. Some women prefer the mini-pill because it can be taken while breast-feeding, and it often reduces menstrual pain and flow and often has fewer side effects than the combined pill.
Combination pills can further be broken down into monophasic, biphasic and triphasic pills. With monophasic pills, the hormone dosage is the same throughout three weeks; the fourth week is the placebo week that allows a woman to have a period. Biphasic pill packs contain one strength of hormones for part of the cycle and another strength of hormones for the other part of the cycle. However, biphasics are less common than triphasics, which come in packs of three different strengths. Typically, that's three sets of seven pills of different strengths plus a week of placebos. However, some brands may use a 5-7-9 combination or a 9-7-5 combination instead. Some doctors and women prefer triphasics because they more closely mimic the rise and fall of hormone levels in a woman's natural menstrual cycle. - Oral contraceptives can have a variety of features that make one brand a better choice over another depending on the specific woman's body chemistry. For women who tend toward anemia, some oral contraceptives provide a low dosage of iron supplement in the placebo week pills. Some combined pills have different ratios of estrogen to progestin and this can make a difference in how some women experience side effects. In recent years, one brand of birth control pills "Seasonale" has eliminated the placebo week for two out of three months so that a woman has a menstrual period only once every three months rather than once every month. This can be an attractive feature for women who experience intense menstrual cramps or other premenstrual symptoms.
- While it's a good idea to do research about medications you are taking, it's not generally recommended that a woman set her mind on what oral contraceptive she wants to use before a doctor's appointment to get a prescription. It's perfectly fine for her to tell the doctor what her preferences are, but sometimes a woman's decision is based on advertising copy rather than facts. Doctors will know how to match your specific needs to a particular kind of birth control that would be best for you. Considerations include how faithful you are about taking medications at exactly the same time every day, how large or small a failure rate you're comfortable with, what side effects you've had from taking other brands of birth control in the past and pre-existing medical conditions.
- Two major misconceptions or myths about oral contraception are that taking the pill will make you gain weight and taking the pill will decrease your fertility, making it harder to get pregnant after you stop taking oral contraceptives. While weight gain of a few pounds--usually bloating from water--does happen to some women on some types of oral contraceptives, this isn't a guaranteed side effect. Switching to a pill lower in progestin often solves the fluid retention and weight gain problem. Also, there's no evidence that taking oral contraceptives for any period of time will later lead to problems getting pregnant when you are ready to start a family. A woman's natural cycle almost always resumes within a month or two of discontinuing her oral contraceptives.
- Both mini-pills and combined pills tend to make periods lighter and reduce menstrual cramps. The combined pill also offers some protection against acne, iron deficiency and many premenstrual syndrome symptoms. Oral contraceptives are also a first-line treatment for Polycystic Ovary Syndrome (PCOS), a hormone imbalance that can cause acne, unwanted facial hair and irregular periods.
