Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
For some, contraception is an invention matching the discovery of Copernicus. Others see it as the cause of the demographic crisis in Europe. There are those who consider it a sinful instrument of Satan. The contraceptive pill is celebrating its 50th birthday and is doing well.
Multiple roles of contraception
The advent of the contraceptive pill was not just a medical invention. It was also associated with the change of the role of women in society. As emphasized by feminists, the woman stopped dealing only with giving birth and raising children. She was able to educate herself and develop her own professional career. She could also derive satisfaction from sexual intercourse without risking an unwanted pregnancy. The demand for effective contraception also grew along with the conviction that it is not enough to bear a child, it is also necessary to bring it up and educate it, which requires both time and money. However, opponents of the pill still believe that it is an unnatural method of contraception.
– If a man would adapt to the rhythm of nature, he would have intercourse primarily in the fertile period of a woman, for whom the most favorable moment of getting pregnant for the first time would be the age of 16 – says Professor Romuald Dębski, Head of the Second Clinic of Gynecology and Obstetrics, Bielański Hospital in Warsaw. – Medicine has reduced the influence of nature on human life so significantly that today it would be hypocritical to pretend that there are no glasses, antibiotics or transplants – he adds.
History of contraception
People in ancient times saw a connection between sexual intercourse and the birth of children. They did not know, however, that it is possible to become pregnant at a certain point in a woman’s menstrual cycle. Ancient contraception therefore focused primarily on preventing male sperm from reaching the interior of a woman. Effective observations were made on animals first.
Many hundreds of years ago, Bedouins, before the caravans set off into the desert, put stones in the womb of the camels so that they would not become pregnant during long journeys. In Egyptian papyri from 4000 years ago, it was discovered that women were instructed to put on a vaginal mass of crocodile excrement mixed with dough.
Australian aboriginal women removed semen from the vagina by making jerky movements and shaking their hips. The ancient Greeks recommended squat sneezing after intercourse, and the “father of medicine” Hippocrates was a supporter of rinsing the vagina with a stream of urine. The father of the modern condom was the XNUMXth-century Italian physician Gabriele Falloppe. The first condoms were made from animal intestines, swim bladders from fish, and in America from snake skins. Before World War II, the German doctor Ernest Grafenberg placed the so-called “Grafenberg rings” consisting of German silver (an alloy of silver with copper). Grafenberg’s pioneering work was condemned by the German Gynecological Society, which forced him to emigrate to the United States.
Estrogen and progesterone in contraception
– A milestone in the history of contraception was the discovery of hormones related to the menstrual cycle – the dominant estrogen in the first phase and progesterone in the second phase – explains Prof. Romuald Dębski. It has been noticed that pregnant women and women who have intercourse with progesterone dominance during the cycle do not become fertilized. In the XNUMXs in the USA, the Jew Gregory Pinkus undertook research on the effects of hormones regulating ovulation. He assumed that if a woman becomes infertile during pregnancy, it is necessary to provoke a hormonal situation in her body similar to that prevailing at that time, i.e. to give her progesterone. Earlier, Austrian biologist Ludwig Haberland had injected female rabbits with extract from the ovaries of pregnant rabbits, which made them infertile. The problem was how to get the hormones we needed. Thousands of pig’s ovaries were used to produce them.
The first birth control pill
The chemist, poet and novelist Carl Djerassi is believed to be the father of the contraceptive pill. As a young doctor of chemistry, he led an international team in the USA, which in 1951 invented the first substance that had a similar structure and action to the body’s natural hormone – progesterone. He used plants to produce it. However, in order to register the contraceptive pill, the results of studies conducted so far in animals had to be confirmed in humans. In the United States, from 1873, Comstock’s Law prohibited research into contraception. For this reason, clinical trials were conducted in the American protectorate, where these restrictive bans did not apply – in Puerto Rico.
When the results were confirmed, mental barriers still had to be overcome. American conservatives regarded the contraceptive pill as an anti-Christian and Bolshevik invention for the destruction of the American people. However, in 1960, the first contraceptive pill, Enovid, was registered in the USA. Soon after, birth control pills were produced by 7 American pharmaceutical companies. In the mid-60s, the sales value increased by 50%. each year. In Europe, the first to market the contraceptive was the United Kingdom in 1961. The contraceptive pill was delivered to France only in 1967.
Opponents of contraception
As early as 1968, Pope Paul VI condemned contraception in his encyclical Humanae vitae. Studies have also been carried out to prove the adverse effect of the use of birth control pills on the increase in the incidence of cardiovascular diseases and breast cancer. Opponents of hormonal contraception declared it incompatible with nature. Professor Romuald Dębski admits that the first contraceptive pills actually had a negative impact on women’s health. – The first contraceptive pill contained 10 mg of progesterone equivalent, modern preparations 0,35. So the content was reduced almost 30 times. In addition, the latest preparations imitate the natural physiological cycle of a woman – first they release estradiol, a hormone identical to that produced by the female ovaries, and then the equivalent of progesterone.
The safety of contraception
– Modern hormonal drugs used for a long time not only do not cause the risk of breast cancer, but also reduce the risk of ovarian cancer, endometrial cancer – explains Prof. Debski. He adds that, of course, there are contraindications, such as smoking, which, together with hormonal contraceptives, increases the risk of cardiovascular diseases. Women with liver or gallbladder problems are advised to use hormonal contraception in the form of patches or vaginal rings. Professor Mariusz Bidziński, the President of the Polish Society of Oncological Gynecology, also believes that modern contraceptive drugs are safe provided that the woman observes the regular visits to the gynecologist. Both for women using hormonal contraception and not using such methods of contraception, the frequency of these visits is once a year.
The effectiveness of the pills
– Contraceptive pills are more effective than spermicides or condoms – says prof. Debski. The pill manufacturers provide almost 100% protection against pregnancy. So where do babies conceived during contraceptive therapy come from? Professor Dębski explains that these are extremely rare cases that are the result of irregular taking of tablets. Women forget to take a pill. Therefore, now the pattern of their reception is changing. – Today, the classic model of taking the 21/7 tablet is no longer valid, i.e. taking into account weekly withdrawal periods, when there is bleeding, which is a proof of the lack of pregnancy for the patient. Due to the very high effectiveness of contraceptive drugs and the availability of pregnancy tests, women no longer need such confirmation. Instead, they are offered packets of pills containing 28 tablets for the 28-day cycle. 24 tablets from the package contain hormones and the remaining 4 are hormonally inactive. These empty tablets are introduced, inter alia, to get the patient used to taking the medicine every day – explains Prof. Debski.