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Fifty years after its FDA approval, the Pill has a new calling.
Illustration by Dewey Saunders Published February 19, 2010 at 04:21 PM
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By the time the oral contraceptive known as the Pill was approved by the FDA in 1960, 500,000 American women had already used it—for infertility. Within two years, 1.2 million had prescriptions for Enovid, its trademarked name.
Today, few will dispute the fact that the Pill revolutionized contraception. But it’s also raised serious questions about the use of synthetic hormones. Public concern, in fact, has prompted the Association of Reproductive Health Professionals and Planned Parenthood to launch the public health program, “You Decide: Making Informed Health Choices about Hormonal Contraception.”
According to the ARHP, compliance issues and the dangers associated with synthetic hormones have prompted the introduction of a new chapter in the history of birth control: the promotion of its non-contraceptive benefits. Perhaps most encouraging is its proven protection against ovarian cancer.
A recent compilation of data from several long-term studies of British women shows that those using the Pill for a decade or more reduced their ovarian cancer risk by a third. Beneficial effects were consistent in all subjects, regardless of age or factors like alcohol and tobacco use, and lasted up to 30 years after they went off birth control.
A 2008 study suggests that, after the Pill’s nationwide acceptance in the 1960s, about 200,000 ovarian cancers and 100,000 deaths from the disease have been prevented. Scientists aren’t sure why this is so, but it may have to do with the way the body is tricked into thinking it’s pregnant. In other words, spending years on the Pill may not be all that different from the continuous pregnancies women endured in earlier centuries.
“You’re interrupting your cycles and the way hormones cause the lining of the uterus to thicken,” said Dr. David Holtz, a Paoli-based gynecologic oncologist with Main Line Health.
Research on the Pill’s role in guarding against ovarian cancer is focused on progesterone, the hormone produced by the ovaries. “One theory is that there’s something about progesterone that prevents abnormal blood cells from dividing and growing,” says Holtz. “It may also alter the blood flow to the ovaries.”
Scientists at the University of Rochester in New York first identified progesterone in 1928, nearly 30 years after the initial discovery of hormones. At the time, it was then being studied for its role in preparing the womb for—and sustaining—pregnancy.
Today, the combined oral contraceptive pill is the most commonly prescribed. Like Enovid, it combines synthetic estrogen and progesterone (progestin). Most COCPs now have lower doses of synthetic hormones—especially estrogen, which has been linked to cancer. But its formulation is still designed to mimic the way real estrogens and progesterone work in the female body.
