The birth control pill, colloquially known as the „pill,“ is a hormonal contraceptive method that first came onto the market in the USA in 1960. A year later, it was also available in Germany. When used correctly, the pill prevents pregnancy with a very high probability. The pill gave women unprecedented freedom and self-determination over their bodies. As a result, it has had a significant impact on society in industrialized countries. Today, around 200 million women worldwide use the contraceptive pill. In Germany, the pill is just as popular (34%) as the condom (38%).
Advantages of the contraceptive pill
(Disadvantages of the birth control pill follow below)
– Birth control with the pill is convenient and easy. It is also considered very safe, significantly safer than natural contraceptive methods, for example.
– Taking the birth control pill allows for optimal cycle control. The woman knows exactly when she will get her period and can postpone it for a few days if necessary. (Competitive athletes like to make use of this).
– The pill has no effect on fertility. After discontinuing the pill, most women become pregnant after one cycle, regardless of how long they have been taking the preparations beforehand.
– Taking the pill reduces the duration and strength of menstruation, which is usually associated with less pain. Taking the pill can significantly reduce the symptoms of endometriosis.
– Some preparations can reduce acne, so they are preferably prescribed to young women with skin problems. The positive effects on the skin result from the fact that taking the pill reduces the concentration of male sex hormones in the blood. However, the effect against acne is not an approved medical indication of the pill.
– Furthermore, it has been proven that combined preparations reduce the risk of developing ovarian cancer and cancer of the uterine corpus. This is the case up to 30 years after stopping the pill. With regard to other cancers, there are positive study data, but these are not yet confirmed.
– The mini-pill contains a mixture of active ingredients with extremely little estrogen. It is suitable for women who cannot tolerate hormone treatment with estrogen.
The birth control pill and its side effects: Disadvantages
Today, the market offers more than 50 different hormonal contraceptives. Although they are convenient, they are not free of side effects. In particular, the long-term effects have caused the pill to lose some of its popularity. Sometimes, however, the symptoms can diminish with prolonged use. Whether micropill, minipill or „normal“ birth control pill, all preparations influence the hormone balance of the woman.
Since every woman reacts differently to hormones, the side effects can vary greatly. If the pill is discontinued, it can take several months before the normal cycle is restored. Likewise, it is possible for a woman to become pregnant after a very short time. Minipills in particular have the disadvantage of causing irregular cycles and intermittent bleeding. These preparations can also be taken during breastfeeding, as they do not affect milk formation or milk quality. Breastfeeding women who are still concerned about their baby absorbing hormones with breast milk must choose another method of contraception.
The most common side effects are:
- Headache
- Nausea and vomiting
- Bleeding between periods
- Water retention
- mood swings
- depressive moods
- weight gain
- decrease in libido
- Blood clots, thromboses and embolisms
Cancer risk from the pill – yes or no?
The pill must always be taken after an individual risk-benefit assessment. If the pill is taken for a long time (25 to 35 years), doctors assume a marginally increased risk (0.1%) of cervical cancer and breast cancer. However, women who take the pill have a lower risk of ovarian cancer.
The pill increases the risk of thrombosis
One of the most important and also most serious complications is thrombosis. Women with other risk factors are especially at risk. These risk factors are smoking, obesity, diabetes mellitus, high blood pressure and family history. An increased risk of thrombosis can be detected by a blood test.
Poorer body image
It is undisputed that the pill strongly interferes with hormone balance. Many women would like to be more natural and perceive their bodies better. They feel that their perception is dampened by the pill.
Weaker libido
The pill can weaken the libido, which is rarely desired and can lead to conflicts in the partnership.
Fixed dosing times
The mini-pill must be taken consistently at the same time every day. It is therefore only suitable for women who are well structured. It tolerates only minor deviations in the time of taking the pill.
Interfering factors for the effectiveness of the pill
The contraceptive protection of the mini-pill is no longer guaranteed if the intake is delayed by more than 12 hours or if it is forgotten more than once. Diarrhea and vomiting also affect its contraceptive effect. Antibiotics, but also herbal medicines such as dietary supplements with St. John’s wort, affect the safety of the contraceptive pill. Time differences must be taken into account when traveling. In the case of time differences up to a maximum of 12 h (usually all travel destinations within Germany), women can take the pill as usual at the vacation destination. In the case of flights in a westerly direction, the interval between doses is increased. Information in the package insert and gynecologists provide precise details.
Brief history of the development of the contraceptive pill
The idea of using hormones for contraception was pursued by doctors as early as 1919. Margaret Sanger and Katharine McCormick, both women’s rights activists and active in the medical field, provided the decisive impetus for this.
Margaret Sanger, a nurse, saw women every day in her work environment who suffered from the consequences of unwanted pregnancies and died after amateurishly performed abortions. Both women were committed women’s rights activists and strove for large-scale education about contraception. In 1921, they founded the „American League for Birth Control.“
In 1951, Sander met endocrinologist Gregory Pincus and asked him how much money he would need to develop a hormonal contraceptive. He estimated far less than was ultimately needed, but received it from the wealthy Katharine McCormick, a friend of Sander’s. She supported the project with a total of $2 million.
Together with other scientists, Pincus succeeded in artificially producing the hormones progesterone and estrogen. Their successes are inconceivable without the work of the German chemist Adolf Butenandt. He succeeded in isolating hormones after years of experimentation. He thus created the chemical basis for the production of the birth control pill. In 1939, Butenandt was awarded the Nobel Prize in Chemistry for his research into sex hormones.
When the pill became available in Germany in 1961, there was considerable opposition from the churches. They feared a decline in morals. Initially, the pill was not intended for contraception, but as a medicine for menstrual cramps. Doctors prescribed it only to married women with children. The manufacturer Schering mentioned the contraceptive effect only as a side effect in the package insert, but it was tantamount to a revolution.
A new era dawns: the sexual revolution
It was the Pill that made the sexual revolution of the 1960s possible, but the innovative contraceptive did not catch on right from the start. This was not only because the Catholic Church protested against it; women themselves (50%) were also skeptical about the pill. This was shown by surveys conducted by the Allesbach Institute in 1963, which even called for the pill to be banned in Germany. More than 60% of those surveyed agreed with the churches‘ view that the pill had a negative influence on morals. Although Pope Paul VI even banned the pill in his encyclical, he was ultimately unable to make much of a difference. Women’s joy at finally being freed from the fear of an unwanted pregnancy was too great. From now on, fertility and sexuality were separate spheres of life.
How does the birth control pill work? How it works
The hormones estrogen and progestin contained in the pill suppress the maturation of the female egg in the ovary, thus preventing ovulation. The hormones also affect the mucous membrane of the cervix, because throughout the cycle the cervix remains closed with a plug of mucus. This prevents sperm from entering the uterus. The hormones also significantly weaken the build-up of the uterine lining. If, contrary to expectations, ovulation were to occur, a fertilized egg would not be able to implant here.
How is the contraceptive pill taken?
The individual instructions for taking the pill vary from preparation to preparation. Women take the tablets continuously, based on a 28-day cycle. The first tablet is taken on the first day of menstruation for all preparations. After 21 days, there is a seven-day break. During this time, the hormone levels drop and a weak menstrual period begins. On day eight, a new pack is started again. There are also preparations that provide for continuous tablet use. In this case, the tablets taken during the period do not contain any active ingredients.