The Development of the Pill and its Impact on Society

The Development of the Pill and its Impact on Society

Student XXXXX

December 19, 2006

Freshman Seminar=

Larry Boles

Outline

=

Purpose: To give an introduction of Oral Contraceptive= s and its impact on society.

Thesis: The introduction of the birth control pill in = the United States marked both an end and a beginning to society.

Audience: Professor, Larry Boles

The Develop= ment of the Pill and its Impact on Society

=

I. Introduction of the birth control pill

   &nbs= p;        A. United States in 1960

   &nbs= p;        B. Initial formulations

   &nbs= p;        C. Impact on various aspects of social life

   &nbs= p;        D. Issues concerning the pill

   &nbs= p;        E. Safety of oral contraceptives/health benefits

II. Birth control movement

   &nbs= p;        A. Early 20^th Century

   &nbs= p;           1. Margaret Sanger (a nurse)=

   2. Katharine McCormick (a wi= fe of the heir to the International Harvester        =             &nb= sp;            =             &nb= sp;

        =            (fortune)

   &nbs= p;        B. Stages in approval of the pill

1. Parke-Davis (scientist)

   &nbs= p;        2. Searle (scientist)

III. Issues concerning the pill

   &nbs= p;        A. Health issues

   &nbs= p;        1. Common side effects

   &nbs= p;        2. Cardiovascular effects

   &nbs= p;        3. Role of steroid amount

   &nbs= p;        B. Legal issues

   &nbs= p;        1. State laws

   &nbs= p;        C. Religious issues

   &nbs= p;        1. Roman Catholic Church

   &nbs= p;        D. Psychosocial issues

   &nbs= p;        1. Women being more independent

   &nbs= p;        2. Greater control over fertility<= /p>
   &nbs= p;        3. Pursue personal life goals

   &nbs= p;        E. Economic issues

   &nbs= p;        1. Cost of pill

   &nbs= p;        2. U.S. government (1964)

   &nbs= p;        3. Federal and State funding

   &nbs= p;        4. Lowey Amendment

   &nbs= p;        F. feminist issues

   &nbs= p;        1. Discriminatory population-contr= ol mechanism

   &nbs= p;        2. Exploitative approach to testin= g the pill

   &nbs= p;        3. Potential harm to women’s health

IV. Safety of birth control/health benefits

A. Evolution of the pill do= se

1. Changes in the pill content

B. Identification of women = with risk factors

C. (OCs) outweigh the poten= tial cardiovascular risks

D. (OCs) expand far beyond pregnancy prevention

1. Extensive body of evidence

   &nbs= p;        2. Moderate acne vulgaris

   &nbs= p;        E. Valuable in the management of a variety of gynecologic disorders

V. Conclusion/wrap up

   &nbs= p;        A. Epochal event in human history

   &nbs= p;        B. Contraceptive efficacy in the U.S.

   &nbs= p;        C. Improved and safer (OCs)

   &nbs= p;        D. Health benefits

Research Paper

The introd= uction of the birth control pill in the United States marked an end a= nd a beginning to society. It marked the end of a moderately short period of tim= e to deliberately produce an oral contraceptive, and the beginning of a relative= ly long period of controversy surrounding the use of the pill (Tyrer, 1999). In 1960, Oral Contraceptives (OCs) were initially approved for unrestricted use and have been used and studied expansively for 30 years. The initial formulations contained a set dose of estrogen and progestogen consumed for = 21 days, with a 7-day pill-free interval (Mishell, 1991). The pill had a huge impact on various aspects of social life including women’s health, fertility trends, laws and policies, religion, feminist issues, gender relations, etc. Although, the earlier formulations of the pill resulted into safety issues, the continued evolution of pill hormones and doses resulted = in a greatly improved and safe oral contraception (Tyrer, 1999).

The birth = control movement started in the early 20^th century by two women named Margaret Sanger and Katharine McCormick. Sanger, a visiting nurse in New York City, saw firsthand the ill effects of uncontrolled childbearing and unsafe abortions= . This motivated her and others to work toward the availability of contraception f= or all women who needed it the most. In 1917, she met McCormick, a wife of the heir to the International Harvester fortune. McCormick quietly lent support= to the birth control movement as well as used her substantial inheritance to actively promote contraceptive research. In 1950, Sanger and McCormick collaborated to find scientists with the essential knowledge to develop a contraceptive pill (Connell, 1999). The scientist, Parke-Davis, applied for= FDA approval of the Syntex product, Norethindrone (Norlution). The other scient= ist, Searle, applied for FDA approval of its progestin, Norethynodrel (Enovid). = Even though the pills were FDA approved, they were specifically limited to the treatment of gynecologic disorders. Ultimately, in 1959, Searle risked marketing the birth control pill when it applied for an indication for the = contraceptive, Enovid. In 1960, the FDA approved Envoid, the 1^st drug for contraception. In 1962, the FDA approved Ortho –Novum, the 2^{nd
drug for contraception (Tyrer, 1999).}

            Although the pill had FDA approval which led to its use by increasing numbers of wom= en, many issues and concerns still faced health professionals as well as women using the pill. One of the ma= jor concerns associated with the early pill, which contained high doses of hormones, was related to possible health effects. The most common side effects inclu= ded headache, nausea, and dizziness. Yet, serious cardiovascular effects were observed in a small proportion of users, plus stroke, venous thromboembolis= m, and myocardial infarction. The relation to the amount of steroids for serio= us adverse effects of the pill was a major focus of pharmaceutical companies as well. In addition, legal issu= es were concerning the dissemination of the pill. In the late 1950s, 17 states= had laws limiting the sale, distribution, or advertising of contraceptives. Moreover, religious issues surrounded the pill and its violation of certain religious prohibitions against contraception. The pill was considered a sin= on a daily basis to Roman Catholics. Furthermore, psychosocial issues were cau= sed by women using the contraceptive pill. The women were able to use the pill independently without relying on her partner to use a condom or have to pre= pare herself with another related method. Therefore, the pill had led to greater control over her fertility. By women being able to limit the number and determine the timing of pregnancie= s, she would be in the position to pursue her personal life goals. Also, econo= mic issues were on the rise due to the cost of the pill. The cost was approxima= tely $10 each month, which was considered expensive 40 years ago. In 1964, the <= st1:country-region w:st=3D"on">U.S. go= vernment established a pilot project with Federal support of birth control for the p= oor. In 1994, Federal and state funding for contraceptive services and supplies totaled $715 million. The Con= gress passed The Lowey Amendment in 1999, which made it a requirement for Federal Employees Health Benefits to provide contraception coverage. Lastly, femini= st issues concerning the pill had been questioned. Some women viewed the pill = as a discriminatory population-control mechanism as well as being a “harmf= ul” method of its early adverse effects. Another aspect was focused on what was considered an exploitative approach to testing the pill and the early tests were carried out on non American women in Puerto Rico= , Haiti, and Mexico.= The fact that the pill had high dose formulations and men couldn’t use it, made women think that it was potentially unsafe (Tyrer, 1999).

            Since the beginning of hormonal contraceptives in the 1960s, there have been a variety of both health benefits and safety concerns recognized to their use (Burkman, 2004). The content and dose of its steroid components have changed significantly. Studies show that from 1964 to 1988, there has been a steady decline in mean estrogen and progestin doses in all formulations as well as= the types of steroids used. In addition, the improved safety profiles relates to the recognition of women with the risk factors such as smoking, high blood pressure, history of cardiovascular disease, and diabetes with vascular disease. Now, there are better selections of users on who choose to use the pill (Tyrer, 1999). Moreover, the oral contraceptives outweigh the potential cardiovascular risks. In a recent meta-analysis, there is a reduction in the risk of endometrial and ovarian cancer. Furthermore, other benefits of the = pill include reduction in menstrual-related symptoms, fewer ectopic pregnancies,= and possible protection against pelvic inflammatory disease (Burkman, 2004). Al= so, the pill protects women against dysmenorrhea and menorrhagia, iron deficien= cy anemia, benign breast disease, ovarian cancer, etc. FDA has stated that an = OC is an effective treatment for moderate acne vulgaris. The pill has been pro= ven valuable in the management of a variety of gynecological disorders including dysfunctional uterine bleeding, mittelschmerz, endometriosis, pelvic pain, = etc (Kauntiz, 1999).

            The introduction of the pill stands out as an “epochal” event in hu= man history. It has forced society to reexamine many long-standing beliefs that seemed to come together at the point of women’s control over her fertility. 80% of the Unites States women have used the pill for an average= of 5 years. The pill has been proven to be highly effective from the start (Ty= rer, 1999). As Tyrer says, “Although rare safety issues developed with the= earlier formulations, continued evolution of pill content and hormone dose has resu= lted in a greatly improved and safer oral contraceptive” (Tyrer, 1999). Th= ere is better patient selection from the clinical refinements in the identifica= tion of risk factors. In addition = to contraceptive efficacy, a wide range of significant health benefits is associated with the pill (Tyrer, 1999). Overall, the development of the pill has made a huge impact on our society…

Works Cited

Burkman, Ronald. "Safety concerns and health bene= fits associated with oral

contraceptive." Ame= rican Journal of Obstetrics and Gynecology 190.4(2004) S5-S22. <http://www.sciencedirect.com>.

Connell, Elizabeth. "Contraception in the prepill era." Contraception 59.1(1999) 7S-10S.

<http://www.sciencedirec= t.com>.

Kaunitz, Andrew. "Oral contraceptive health benef= its: perception versus reality."

Contraception 59(199= 9) 29S-33S. <http://www.sciencedirect.com>.

Mishell, Jr. "Oral Contraception: past, present, = and future." Int J Fertil 36(1991) 7-18.

<http://www.sciencedirec= t.com>.

Tyrer, Louise. "Introduction of the pill and its impact." Contraception 59.1(1999) 11S-

16S. <http://www.sciencedirect.com>.