Oral Contraceptive Pill

There is good news about oral contraceptives, says an editorial in the New England Journal of Medicine (NEJM).

“The development of oral contraceptives stands as a major advance in women’s health in the past century. By virtue of their ability to prevent pregnancy in 99 percent of women who use them properly, oral contraceptives have revolutionized reproductive choices for women,” says the editorial.

How safe is the oral contraceptive, also known as “the pill”?

A study in 1986 did not show any association between oral contraceptive use and breast cancer. But ten years later, studies of oral contraceptive use showed that women had a slightly increased risk of breast cancer while on the pill. But there was no increase in the breast cancer rates 10 years after quitting the pill.

So, what’s the good news now?

A well-conducted, population-based study, published in the recent NEJM, shows no association between past or present use of oral contraceptives and breast cancer.

That indeed is very good news for women who are currently on the pill or who have been on the pill in the past.

And there is more good news in the NEJM!

Use of oral contraceptives reduces the risk of uterine cancer by 40 percent after 12 months of taking the pill. There is also a 40 percent reduction on the risk of ovarian cancer after as short a period as three to six months of use, and 10 or more years of use was associated with an 80 percent reduction in the risk of ovarian cancer.

But nothing is hundred percent safe in life. Use of the pill is associated with some side-effects in a small percentage of women. These are:

-Deep vein thrombosis (blood clot in the legs)
-Pulmonary embolism (blood clot in the lungs)
-Stroke
-Liver cancer
-Heart attack in women over 35 years of age who smoke

But for most women, the advantages of the pill out weigh disadvantages. Besides the benefits mentioned earlier, there are other advantages to using the pill:

-Greater regularity of menstrual cycle
-Reduced menstrual blood loss and hence prevention of anaemia
-Reduced incidence of painful periods

Today, despite the threat of AIDS, users of oral contraceptives outnumber condom users by two to one. There are approximately 100 million women world-wide who use the pill. And these women should be thankful to a nurse named Margaret Sanger. In 1914, Sanger defiantly championed women’s right to have sex without fear of pregnancy in “The Woman Rebel”.

Based in Brooklyn, Sanger spread the gospel of voluntary motherhood relentlessly, says the Life Millennium book on the 100 most important events and people of the past 1000 years. Her birth control clinics were raided by the police and in 1914 she also faced an obscenity charge which was later dropped.

In 1960, six years before Sanger’s death, the U.S. Food and Drug Administration approved the birth control pill. One of the developers of the pill, Dr. Gregory Pincus, dedicated his research to Sanger’s “pioneering resoluteness”. The pill was cheap, convenient and reliable. It instantly became popular with doctors and patients.

So where do we go from here?

Women’s right to have sex without fear of pregnancy has been established. The next challenge for the scientists is to develop a pill which will have no side-effects affecting the heart and the lungs.

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