Introduction of the pill and its impact

Abstract

Introduction of the birth control pill in the United States in 1960 marked the end of a relatively short period of time (< 10 years) to intentionally produce an oral contraceptive, and the beginning of a relatively long period of controversy surrounding the use of the pill. Availability of the pill had an impact on various aspects of social life, including women's health, fertility trends, laws and policies, religion, interpersonal relationships and family roles, feminist issues, and gender relations, as well as sexual practices among both adults and adolescents. The pill proved to be highly effective from the outset. Although safety issues developed with the earlier formulations, continued evolution of pill hormones and doses has resulted in a greatly improved and safe oral contraceptive. A broad range of noncontraceptive health benefits also is associated with the pill. These health effects are significant, as they include protection against potentially fatal diseases, including ovarian and endometrial cancers, as well as against other conditions that are associated with substantial morbidity and potential hospitalization and associated costs. The popularity of the pill has remained high, with rates of use in the past 30 years in the United States ranging from one-quarter to almost one-third of women using contraception. Almost 40 years after its introduction, the pill's contraceptive efficacy is proven, its improved safety has been established, and the focus has shifted from supposed health risks to documented and real health benefits.

PIP: By the end of their reproductive years, more than 80% of US women will have used oral contraceptives (OCs), for an average of about 5 years. The pill has had a dramatic impact on social life in the US, affecting women's health, fertility trends, laws and policies, religion, interpersonal relations, family roles, women's careers, gender relations, and premarital sexual practices. The emergence of the women's rights movement of the 1960s and 1970s was significantly related to the availability of the pill and the control over fertility it enabled. This capability allowed women to make choices about other life arenas, especially work. Over the past 40 years, both the content and dose of the steroid components of OCs have changed significantly, with consequent reduced health effects. This improved safety profile has been further bolstered by the identification of women with risk factors such as smoking, high blood pressure, history of cardiovascular disease, and diabetes with vascular disease. In recent years, the emphasis has shifted from the health risks of OC use to the noncontraceptive health benefits.