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1st appeared
06
June 2000
Party for The Pill, Women’s Liberation At the 40th birthday party for the birth control pill, national contraceptive expert Felicia Stewart says she may not have made it through medical school were it not for the tiny oral medication. Stewart, adjunct professor in the UCSF department of obstetrics, gynecology and reproductive sciences, described her monthly cycles as "grisly." In the four decades since it was made available in the US, the pill has been liberating women in many ways besides providing highly effective contraceptive protection, Stewart says. "It gives women control over their own cycles. Before the pill, many young women suffered through disabling menstrual problems that kept them in bed in agony for several days each month, and there was little we could do to help them. For other women, abnormal hormone patterns causing unpredictable or prolonged bleeding were also a source of difficulty. For these situations, birth control pills provide a simple treatment with few risks or side effects. Women can be spared the mayhem and aggravation they used to go through." Stewart was among the 40 women and two men to celebrate how the medication fundamentally changed the way many women control their fertility and their menstrual cycles at a May 31 party organized by the UCSF Center for Reproductive Health Research & Policy. Following talks focusing on the past, present and future of the pill, attendees were offered cake and champagne. About 10 million US women take the pill for birth control, according to the journal Family Planning Perspectives, and more than 50 million have ever used this method. Today’s birth control pill is not the same as the pill approved by the FDA in 1960. One of the most significant changes is that they have much lower levels of estrogen and progesterone, the two hormones present in most pills, says Stewart, co-director of the center. This means today’s pills cause fewer side effects such as nausea and breast tenderness than did the pills introduced in 1960. Another important innovation is use of oral contraceptives for emergency contraception — ordinary pills used in two strong hormone doses soon after unprotected intercourse to prevent pregnancy. In 1997, the FDA approved this approach, and in 1998 and 1999 the first products specifically for emergency treatment — Plan B and Preven — became available in the US. "The truth, of course, is that we knew about this method for 24 years," says Stewart, who prior to joining the faculty of UCSF served as Deputy Assistant Secretary for Population Affairs for the US Department of Health and Human Services. Emergency contraceptive treatment -- which works by preventing ovulation, fertilization or implantation -- is most effective when taken during the first 12 hours after intercourse, but can be started up to 72 hours later, Stewart says. Because of the relatively short timeframe, Stewart says she believes the medication should be made available to women over the counter, rather than waiting for a prescription to be filled. The pill has helped to usher in a new wave of contraceptive methods for women that most likely will be available in the next few years. "We will have five new methods within a very short period of time that will be introduced in the US after a long drought," Stewart says. Indeed, Stewart says that the US has one of the highest rates of sterilization compared to the rest of the world, a fact that points to the level of dissatisfaction with available contraceptive methods. These new methods include a skin patch worn on the hip for a week, tubes to be inserted into the arm similar to Norplant that would provide protection for three years and a vaginal ring that provides protection against pregnancy for a month. "The more choices we have the more likely couples are going to be able to find a birth control method that they can use with success," says Phil Darney, UCSF professor in residence in the department of obstetrics and gynecology and co-director of the center. "One reason the unintended pregnancy and abortion rates are high in this country is because we don’t have as many contraceptive choices as women in European and Asian countries have. The more methods we have, the better." Darney, who will testify before the FDA next month on the proper use of the pill and labeling practices, says RU-486, the abortive made available in France for 12 years, has not been approved for market by the FDA. "The timing [for approval] ranges from the next few months, among optimists, to maybe never depending upon the outcome of the [presidential] election." Darney and colleagues at San Francisco General Hospital Medical Center showed in clinical trials that the use of RU-486 taken five days after intercourse achieved almost a 90 percent reduction in unintended pregnancies. Launched about a year ago at UCSF’s Laurel Heights site, the Center for Reproductive Health Research & Policy works to promote reproductive health in women and adolescents. Source: Leslie Harris, News Services, and Lisa Cisneros, Newsbreak Editor |
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