Oral Contraceptives: More than Just Birth Control

One of my favorite colleagues over the years has been Dr. George Huggins. He's retired now and enjoying the sunny life in Arizona, but he used to tell me stories about the good old days--like when he went to work with some colleagues at the University of Pennsylvania to develop some of the first birth control pills. It was the 1960s, a time when both women and medicine were evolving quickly.

Dr. Huggins and researchers like him discovered that using the female hormones estrogen and progesterone in a pill could fool the body into not ovulating--the ovaries wouldn't release an egg. And no eggs, no babies. What the researchers didn't realize at the time, however, was that these pills could have other, significantly positive effects on the body.

The point is that oral contraceptive pills (OCPs) were originally meant for birth control but they have become so much more!

Birth Control Pills and their Side Effects

The early pills contained high doses of the two hormones, which meant that the side effects were much more pronounced than they are today. With time, we've discovered that lower doses can be equally effective at stopping ovulation, while producing fewer and more manageable side effects.

Today, common side effects of these pills include breast tenderness, nausea, and mood swings.

Blood Clots

The greatest risk of taking The Pill is that it slightly increases your chances of developing a blood clot that could lead to a stroke, heart attack, or lung blockage. People who have a genetic predisposition to these clots should never take anything that increases that risk.

Smokers and women over 35 also have a higher risk of blood clots when they are taking The Pill. Therefore, it follows that smokers over 35 should not take The Pill. The average woman, however, when she is pregnant, is six times more likely to develop such a clot than when she is taking The Pill.

Some past research results suggested an increased risk of breast cancer among women who use The Pill, but research that is more recent has not shown this risk to be significant. An increased risk of cervical cancer has been demonstrated in users of The Pill, however--but since we now know that the human papilloma virus (HPV) is the primary cause of this cancer, this link is not completely understood.

So what else can The Pill do?

As their name implies, birth control pills and oral contraceptives were initially developed to stop pregnancy. But it soon became evident that women taking The Pill were enjoying some other side benefits that were pretty significant, and so providers began prescribing The Pill for reasons other than stopping pregnancy.

For one thing, The Pill suppresses ovulation and thins the uterine lining--a side effect that relieves many women of the symptoms of painful, heavy periods. Another of The Pill's pluses: Ovarian cysts, which develop at the site of ovulation, are less likely to form if there's no ovulation. OCPs are also the first-line treatment for women with something called polycystic ovarian syndrome, a disorder where the ovaries, rather than ovulating properly, form multiple cysts.

Against Certain Cancers

Since OCPs decrease the number of ovulatory cycles, we now know that using them for one year decreases a woman's risk of ovarian cancer by 10 percent to 12 percent; after five years of use, this risk declines by over 50 percent! And by thinning the uterine lining and preventing overstimulation of the lining, OCPs can reduce the risk of endometrial cancers. These actions by OCPs can also thin endometriosis implants, rendering them less painful.

A Break from PMS

We used to think that the uterus should be allowed to bleed occasionally; in recent years, however, we've discovered that women can take The Pill continually, and that she need not take even an occasional break from The Pill. This means that she needn't experience any bleeding at all, or that she can take a few days off from her OCPs here and there, at whatever time intervals she chooses, to allow for shedding of any minimally accumulated uterine lining. The upshot of all this is that, suddenly, women who have suffered for years with menstrual headaches, severe PMS symptoms, and many other menses-related maladies can simply skip that whole nightmare!

And Last but Not Least

OCPs can have a positive effect on the hormones that contribute to acne, decreasing this dermatologic scourge. In fact, the FDA has approved certain OCPs for acne treatment.

We've Come a Long Way Baby

Yes, as women, we have evolved at an ever-quickening pace, at a time when we've been able to delay, space out, or skip childbearing entirely. But these choices can result in a significant increase in ovulatory cycles, with all the resulting increases in ovarian- and endometrial-cancer risks. And of course more periods mean more PMS, painful periods, ovarian cysts, acne, etc.

So our bodies have struggled at times to keep up with all these changes and advances, and often the speed at which we are progressing has left our ovaries and uteruses scrambling to catch up. But because of heroes like Dr. Huggins, we are keeping up--often with the help of OCPs. We just have to realize that The Pill is for more than birth control.

OCPs are obviously not right for everyone, but they might be worth discussing carefully with your health care provider if you are suffering and feel like they could help you.

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