Q and A: The 50th Anniversary of ?The Pill? | Science Gobble

By Rihard Raza | February 18, 2012

The pill. Oral contraception for women has been about for 5 decades.

Credit: Wikimedia Commons

VANCOUVER, CANADA?In the past half century, few items have transformed society as profoundly as oral contraceptives. Initial introduced as the FDA-approved drug Enovid in 1961, ?the pill? operates by delivering a constant provide of estrogen and progesterone, which block the hormones that lead to ovulation. About 85 percent of girls in the U.S. will take contraceptive drugs for an typical of 5 years. Offered its widespread use by a normally healthy and young population, what is identified about the risks and rewards of oral contraception? What are the alternatives? And when will we see ?the pill? for men?

Yesterday, Ronald Burkman, a obstetrician/gynecologist at Tufts University School of Medicine, gave a speak on these topics at the annual meeting of the American Association for the Advancement of Science (which publishes ScienceNOW). I sat down with him to chat about 50 years of the contraceptive ?wonder drug?.

What interested you in studying contraception?

Its substantial public wellness impact. When you recognize there are about 34 million unintended, unplanned pregnancies that take place each year, primarily in developing countries, you realize, for nations in sub-Saharan Africa, not getting contraception has a important impact on maternal mortality. If you are in sub-Saharan Africa in some countries, your lifetime danger of dying in pregnancy is 1 in 30. Your lifetime threat of dying of pregnancy in this country is less than 10 per 100,000.

In your speak you asserted the pill?s risks of blood clotting, lung artery blockage, heart attack and stroke are minimal. What about cancer risks?

1 or two cancers could be increased by the pill ? benign and malignant liver tumors ? but those happen at a single per million or one per two million, so it is not a large public health problem. We?ve undoubtedly been searching at women on the pill and the danger of cervical cancer, and there?s some evidence that it may possibly happen, but once again, it doesn?t go quickly to critical cervical cancer. But breast cancer? Not a lot of issue there. In reality, a study that I was involved with looked at females of reproductive age group and identified no increased risk of breast cancer, and we showed that there?s protective effects against endometrial and ovarian cancer.

Other speakers in your session described the pill?s rewards beyond contraception, from menstrual cycle regularity to decreased threat of ovarian and endometrial cancers and increased bone mass. Given these positive aspects, would you tell women to use oral contraception just for their health?

Yeah, you could use it for medical factors. Certainly therapy of endometriosis [a disorder where uterus cells grow outside the uterus], irregular menstrual cycles, young women with dysmenorrhea [painful periods]?it is 1 of the top remedies for it. So there?s a variety of causes where oral contraceptive can be utilised in a non-contraceptive way. But placing wholesome females on anything to say that it has a health benefit? that becomes a prospective problem. And the reality is, a lot of people use it anyway for contraception.

Are these positive aspects linked lengthy-term use only or short-term use also?

1 year of use does offer benefit far more prolonged use supplies additional benefit.

Does the pill have side effects on mood?

It can. It varies from individual to individual. [Some pill formulations] will probably have an improvement [on mood]. Secondly, a lot of men and women worry about weight gain. Well, the data are fairly constant: the pill does not lead to any weight gain.

What are the challenges to developing ?the pill? for men?

Some of the challenges are, is this stuff reversible? Clearly if you tie the tubes ? vasectomy ? it is very, extremely successful. But that?s not what most folks want. Some of the [candidate male contraceptive] drugs, such as high-dose testosterone therapy, have side effects ? potentially even cardiovascular side effects. And [the infertility effect] is not reversible ? fully. So [some of these efforts] fell by the wayside.

Do you feel the principal barriers to developing oral contraceptives for males have been societal or biological?

I can assure you that if [pharmaceutical firms] could develop one, it?d be a blockbuster, so they have a lot of interest in digging through. It?s just the science has not lent itself but so far with any breakthrough that?s reversible, straightforward to use, and so on. If somebody stated here?s a pill you take for a month at a time, I consider men would sign up readily. In reality, nothing?s there. Element of the issue is you currently have a really effective form of contraception. The [contraception] market?s saturated now.

Exactly where do you see the field going?

I consider contraception will be a considerable concern in terms of dealing with excess population growth. It?s how you deal with the unintended pregnancy rate worldwide that?s key. I also take a lengthy term view with global warming. Why do we have some of these effects on earth?s atmosphere? It?s since of the population. In Brazil, they cut down the forest for wood to construct houses. China [implemented] the one kid [rule]. But they also have the other effect ? far more folks went into the middle class, and what do they do? They copied [the polluting U.S. life style]. It really is a massive problem.

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